Villavicencio, Olmedo Ivan
Villavicencio, Olmedo Ivan is an individual health care provider with primary practice located at 7501 Little River Tpke Ste 105 , Annandale VA 22003-2923. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Villavicencio, Olmedo Ivan can be contacted via phone (703) 354-2878.Contact Information
Primary practice address
7501 Little River Tpke Ste 105
Annandale VA 22003-2923
Phone: (703) 354-2878
Fax: (703) 354-2712
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 0401007760 | Virginia |
Profile Details
| NPI number | 1013059450 |
|---|---|
| LBN Legal business name | Villavicencio, Olmedo Ivan |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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