TDG DENTAL GROUP PLLC (NPI# 1992274153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992274153 |
| Entity Type | Organization |
| Organization Name | TDG DENTAL GROUP PLLC |
| Practice Address |
3114 Golansky Blvd Ste 101 Woodbridge VA 22192-4231 |
| Practice Telephone | 7035832800 |
| Mailing Telephone | 7035832800 |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |
| Authorized Official Name | STEPHANIE GOMEZ (CREDENTIALING SUPERVISOR) |
| Authorized Official Telephone | 3052742499 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10630 Crestwood Dr Ste B, Manassas, VA 201094405 | 7033305578 |
| Street Address |
3114 GOLANSKY BLVD STE 101 |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-4231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124645577 | Nada Elsadig | Dentist | 5007 Quell Ct, Woodbridge, VA 22193-8906 | 2020-07-01 |
| 1356902720 | Kevin James Salinas | Dentist | 4893 Prince William Pkwy Ste 101, Woodbridge, VA 22192-5404 | 2019-06-25 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1790209443 | Farzin Ghanavati | Dentist | 14757 Candlewood Ct, Woodbridge, VA 22191-3107 | 2017-08-02 |
| 1508395609 | Syeda Sajia Zafrin | Dentist | 4880 Montega Dr, Woodbridge, VA 22192-5318 | 2017-06-12 |
| 1295151579 | Lake Ridge Dental Care | Dentist | 13625 Office Pl Ste 102, Woodbridge, VA 22192-4270 | 2014-03-11 |
| 1336561315 | Kidz Dental, P.C. | Dentist | 13648 Jefferson Davis Hwy, Woodbridge, VA 22191-2005 | 2014-01-10 |
| 1285075754 | Jayasanker Viayan Valiyaparambil | Dentist | 8 Pumpkin Patch Rd, Woodbridge, CT 06525-2523 | 2013-07-12 |
| 1821434127 | Potomac Mills Family Dental | Dentist | 14338 Gideon Dr, Woodbridge, VA 22192-4640 | 2013-05-14 |
| 1073875936 | Kathryn Smith | Dentist | 1960 Daniel Stuart Sq, Woodbridge, VA 22191-3314 | 2012-06-15 |
| Find all providers in WOODBRIDGE | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
Please comment or provide details below to improve the information on TDG DENTAL GROUP PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.