Provider Demographics
NPI:1316174121
Name:FLEXSENHAR, DIANE DENG (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:DENG
Last Name:FLEXSENHAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11711 BOWMAN GREEN DR
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-3501
Mailing Address - Country:US
Mailing Address - Phone:512-825-2966
Mailing Address - Fax:
Practice Address - Street 1:11711 BOWMAN GREEN DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-3501
Practice Address - Country:US
Practice Address - Phone:703-437-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-18
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246321223G0001X
VA04014181501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice