Provider Demographics
NPI:1588898266
Name:SPERLING, KEREN (DMD, MSC)
Entity type:Individual
Prefix:DR
First Name:KEREN
Middle Name:
Last Name:SPERLING
Suffix:
Gender:F
Credentials:DMD, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MAPLE AVE W STE H
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4312
Mailing Address - Country:US
Mailing Address - Phone:571-234-1344
Mailing Address - Fax:
Practice Address - Street 1:303 MAPLE AVE W STE H
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4312
Practice Address - Country:US
Practice Address - Phone:571-234-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2016-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014123561223P0300X, 1223P0300X
WADE600654751223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics