Provider Demographics
NPI:1932445533
Name:ADAMS SMILE CENTER PLLC
Entity Type:Organization
Organization Name:ADAMS SMILE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAQSOOD
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAUDHRY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-430-1212
Mailing Address - Street 1:46161 WESTLAKE DR
Mailing Address - Street 2:SUITE 220
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:703-430-1212
Mailing Address - Fax:
Practice Address - Street 1:46161 WESTLAKE DR
Practice Address - Street 2:SUITE 220
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-430-1212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223E0200X, 1223G0001X, 1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty