Provider Demographics
NPI:1396812004
Name:FIDEL, ELIDIA CARNEIRO (DDS)
Entity type:Individual
Prefix:DR
First Name:ELIDIA
Middle Name:CARNEIRO
Last Name:FIDEL
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 1:5555 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-5852
Mailing Address - Country:US
Mailing Address - Phone:703-575-9899
Mailing Address - Fax:
Practice Address - Street 1:5555 COLUMBIA PIKE
Practice Address - Street 2:SUITE 102
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5852
Practice Address - Country:US
Practice Address - Phone:703-575-9899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC58861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry