Lake Ridge Dental Clinic

LBN: Dental Family Practice
Lake Ridge Dental Clinic is an health care organization with primary practice located at 12724 Directors Loop , Lake Ridge VA 22192-2462. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Periodontics, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / General Practice is the primary health care specialty. Dental Family Practice can be contacted via phone (703) 494-9171, or through Mostofi, Mina T via phone (703) 494-9171.

Contact Information

Primary practice address
12724 Directors Loop Lake Ridge VA 22192-2462
Phone: (703) 494-9171
Fax: (703) 490-4066
Website:
Map and Directions
Authorized official contact:
Name: Mostofi, Mina T Doctor of Dental Medicine (DMD)
Phone: (703) 494-9171

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0401007810 Virginia
Dental Providers / Periodontics 1223P0300X 0401008961 Virginia
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 0401410790 Virginia

Profile Details

NPI number 1558483305
LBN Legal business name Dental Family Practice
DBA Doing business as Lake Ridge Dental Clinic
Authorized official Mostofi, Mina T Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 4th, 2007
Last updated Jun 23rd, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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