Burke Dental, PLLC

Organization Active NPI General Practice Dentistry · Burke, VA

NPI 1407228463 · NPPES record last updated Oct 29, 2015

Key facts

NPI
1407228463
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
BURKE DENTAL, PLLC
Practice address
9006 Fern Park Dr.
Suite a
Burke, VA 22015
Phone
(703) 978-6000
NPI assigned
Oct 29, 2015
Organization subpart
Yes
Parent organization (as reported)
POTOMAC VALLEY DENTAL CARE, PLLC

Authorized official

Name
Dr. James Willis, DDS
Title
Dentist/Owner
Phone
(703) 978-6000

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Burke Dental (2 organizations share this tax ID)
Part of
Giovanni P Iuculano DDS PC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

9006 Fern Park Dr.
Suite a
Burke, VA 22015

Mailing address

9006 Fern Park Dr.
Suite a
Burke, VA 22015
Phone (703) 978-6000

Other providers in Burke, VA

All providers in Burke, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.