Provider Demographics
NPI:1881454643
Name:ELEGANT SMILES PLLC
Entity type:Organization
Organization Name:ELEGANT SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KASHIF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-386-4001
Mailing Address - Street 1:9749 BUCHANAN LOOP
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-7856
Mailing Address - Country:US
Mailing Address - Phone:703-996-4414
Mailing Address - Fax:703-659-6767
Practice Address - Street 1:9749 BUCHANAN LOOP
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-7856
Practice Address - Country:US
Practice Address - Phone:703-333-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-20
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental