Provider Demographics
NPI:1053010413
Name:HUNTINGTON DENTAL PLLC
Entity type:Organization
Organization Name:HUNTINGTON DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-960-8670
Mailing Address - Street 1:5956 RICHMOND HWY
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22303-1871
Mailing Address - Country:US
Mailing Address - Phone:703-960-8670
Mailing Address - Fax:703-960-0267
Practice Address - Street 1:5956 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-1871
Practice Address - Country:US
Practice Address - Phone:703-960-8670
Practice Address - Fax:703-960-0267
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty