Provider Demographics
NPI:1699577817
Name:DENTALPOLITAN LLC
Entity type:Organization
Organization Name:DENTALPOLITAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRIYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-973-5633
Mailing Address - Street 1:16211 SUNSET VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1087
Mailing Address - Country:US
Mailing Address - Phone:703-973-5633
Mailing Address - Fax:
Practice Address - Street 1:2075 L ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4957
Practice Address - Country:US
Practice Address - Phone:202-991-3737
Practice Address - Fax:202-921-3737
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENTALPOLITAN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty