Provider Demographics
NPI:1316499379
Name:HOMETOWN DENTAL CARE PLLC
Entity type:Organization
Organization Name:HOMETOWN DENTAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:AREZOU
Authorized Official - Middle Name:MASOUMEH
Authorized Official - Last Name:DANESHVAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:412-805-1625
Mailing Address - Street 1:821 S KING ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3921
Mailing Address - Country:US
Mailing Address - Phone:571-363-2244
Mailing Address - Fax:571-363-2255
Practice Address - Street 1:821 S KING ST
Practice Address - Street 2:SUITE E
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3921
Practice Address - Country:US
Practice Address - Phone:571-363-2244
Practice Address - Fax:571-363-2255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-25
Last Update Date:2025-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized EquipmentGroup - Multi-Specialty