Provider Demographics
NPI:1306576418
Name:ALPINE DENTAL CARE
Entity type:Organization
Organization Name:ALPINE DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHRAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-246-9093
Mailing Address - Street 1:1524 LINCOLN WAY UNIT 433
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-5946
Mailing Address - Country:US
Mailing Address - Phone:508-246-9093
Mailing Address - Fax:
Practice Address - Street 1:9255 OLD KEENE MILL RD
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-4202
Practice Address - Country:US
Practice Address - Phone:703-455-0409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty