Provider Demographics
NPI:1679969653
Name:HARTMAN, ALYSSA (DDS)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:WERNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 N FILLMORE STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201
Mailing Address - Country:US
Mailing Address - Phone:703-243-4500
Mailing Address - Fax:703-243-4100
Practice Address - Street 1:1025 N FILLMORE STREET
Practice Address - Street 2:SUITE C
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201
Practice Address - Country:US
Practice Address - Phone:703-243-4500
Practice Address - Fax:703-243-4100
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414811122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist