Premier Dental Group Pllc

LBN: Premier Dental Group Pllc
Premier Dental Group Pllc is an health care organization with primary practice located at 9420 Forestwood Ln Ste 201 , Manassas VA 20110-4758. The organization recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist Anesthesiologist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is the primary health care specialty. Premier Dental Group Pllc can be contacted via phone (617) 943-8812, or through Amirsayafi, Payam via phone (617) 943-8812.

Contact Information

Primary practice address
9420 Forestwood Ln Ste 201 Manassas VA 20110-4758
Phone: (617) 943-8812
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Amirsayafi, Payam
Phone: (617) 943-8812

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist Anesthesiologist 1223D0004X
Dental Providers / Pediatric Dentistry 1223P0221X

Profile Details

NPI number 1063971281
LBN Legal business name Premier Dental Group Pllc
DBA Doing business as
Authorized official Amirsayafi, Payam
Entity Organization
Organization subpart 1 No
Enumeration date Mar 18th, 2019
Last updated Mar 18th, 2019 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1063971281 NPPES
Virginia MEDICAID 1881968204

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