Provider Demographics
NPI:1124322169
Name:DAVID PAINO DDS, PC
Entity type:Organization
Organization Name:DAVID PAINO DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-281-7104
Mailing Address - Street 1:307 MAPLE AVE W
Mailing Address - Street 2:SUITE A
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4307
Mailing Address - Country:US
Mailing Address - Phone:703-281-7104
Mailing Address - Fax:703-281-2175
Practice Address - Street 1:307 MAPLE AVE W
Practice Address - Street 2:SUITE A
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4307
Practice Address - Country:US
Practice Address - Phone:703-281-7104
Practice Address - Fax:703-281-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-05
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA401411121261QD0000X
VA05322261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6683340001Medicare NSC