Provider Demographics
NPI:1346081254
Name:MONICA R DDS PLLC
Entity type:Organization
Organization Name:MONICA R DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESTREPO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-463-8533
Mailing Address - Street 1:11130 FAIRFAX BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-5035
Mailing Address - Country:US
Mailing Address - Phone:571-407-7030
Mailing Address - Fax:571-407-5301
Practice Address - Street 1:11130 FAIRFAX BLVD STE 100
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-5035
Practice Address - Country:US
Practice Address - Phone:571-407-7030
Practice Address - Fax:571-407-5301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty