Provider Demographics
NPI:1063606093
Name:ARNOLD S. FARIELLO, DDS PC
Entity type:Organization
Organization Name:ARNOLD S. FARIELLO, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:SAL
Authorized Official - Last Name:FARIELLO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-591-4010
Mailing Address - Street 1:10875 MAIN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-4732
Mailing Address - Country:US
Mailing Address - Phone:703-591-4010
Mailing Address - Fax:703-591-3672
Practice Address - Street 1:10875 MAIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-4732
Practice Address - Country:US
Practice Address - Phone:703-591-4010
Practice Address - Fax:703-591-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-03
Last Update Date:2007-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA3718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty