BRITESTARS PEDIATRIC DENTISTRY (NPI# 1801029590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801029590 |
| Entity Type | Organization |
| Organization Name | BRITESTARS PEDIATRIC DENTISTRY |
| Practice Address |
12602 Lake Ridge Dr Woodbridge VA 22192-2335 |
| Practice Telephone | 7034905050 |
| Mailing Telephone | 7034905050 |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2009-08-27 |
| Authorized Official Name | DR. GINA C PHAM (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 7034905050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
0401411775 | VA | Dental Providers |
| Street Address |
12602 LAKE RIDGE DR |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22192-2335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083192397 | Sun Ha Kim | Dentist | 12602 Lake Ridge Dr, Woodbridge, VA 22192-2335 | 2018-07-30 |
| 1043731086 | Kian Zabi Momeni | Dentist | 12602 Lake Ridge Dr, Woodbridge, VA 22192-2335 | 2017-06-29 |
| 1710415716 | Linh Phan | Dentist | 12602 Lake Ridge Dr, Woodbridge, VA 22192 | 2017-06-02 |
| 1922535657 | Jessica Goodman | Dentist | 12602 Lake Ridge Dr, Woodbridge, VA 22192-2335 | 2017-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245873645 | Ursula Jackson | Technician | 3500 Commission Ct, Woodbridge, VA 22192 | 2019-10-18 |
| 1205480779 | Ki Soo Park | Physical Therapy Assistant | 12825 Minnieville Road Suite 201, Lake Ridge, VA 22192 | 2019-08-01 |
| 1801448329 | Karen Lee Trivett | Specialist/Technologist, Other | 12584 Darby Brook Court, Woodbridge, VA 22192 | 2019-07-15 |
| 1407313166 | Nichele Amelia Thompson | Behavioral Analyst | 2731 Marblestone Dr, 101, Woodbridge, VA 22192 | 2019-02-28 |
| 1952877870 | Kimberly Ann Rojas Vazquez | Behavioral Analyst | 12531 Clipper Dr, Suite 203, Woodbridge, VA 22192 | 2018-10-18 |
| 1104391614 | Ykim Dental | Dentist | 2680 Optiz Blvd., Suite 120, Woodbridge, VA 22192 | 2018-10-11 |
| 1013418755 | Arm Transport | Non-emergency Medical Transport (VAN) | 13000 Harbor Center Dr Ste 132d, Woodbridge, VA 22192 | 2018-02-27 |
| 1811496813 | Francesca Nasi | Behavioral Analyst | 12531 Clipper Dr Ste 203, Woodbridge, VA 22192 | 2018-02-05 |
| 1942729504 | Bismark Transportation Service LLC | Non-emergency Medical Transport (VAN) | 12341 Woodlawn Court, Woodbridge, VA 22192 | 2017-09-14 |
| 1992226344 | Arm Baby Eldery Home Health LLC | Home Health | 13000 Harbor Center Dr # 312c, Woodbridge, VA 22192 | 2017-07-06 |
| Find all providers in zip 22192 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093169799 | Bertram Strachan Jr. | Dentist | 148 Strawberry Hill Ave, Woodbridge, NJ 07095-2632 | 2016-04-19 |
| 1043731086 | Kian Zabi Momeni | Dentist | 12602 Lake Ridge Dr, Woodbridge, VA 22192-2335 | 2017-06-29 |
| 1245531805 | Dr. Mala Britto's Children's Dentistry | Dentist | 12581 Milstead Way, Suite 305, Woodbridge, VA 22192-5445 | 2010-11-12 |
| 1992935449 | April Joy Johnson Toyer | Dentist | 14573 Potomac Mills Rd, Woodbridge, VA 22192-6808 | 2009-07-18 |
| 1487839288 | Joseph Silverman Dmd LLC | Dentist | 655 Amboy Ave, Suite 301, Woodbridge, NJ 07095-3159 | 2007-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750998878 | Nadgie Ortiz Diaz Dmd Pllc | Dentist | 24560 Southpoint Dr Ste 240, Aldie, VA 20105-3505 | 2020-09-24 |
| 1154948289 | Cardinal Pediatric Dentistry Pllc | Dentist | 11551 Nuckols Rd Ste H, Glen Allen, VA 23059-5565 | 2020-07-06 |
| 1043842214 | Funpedopark LLC | Dentist | 1009 Centerbrooke Ln Ste 210, Suffolk, VA 23434-8664 | 2020-02-06 |
| 1861023251 | Bitty Bites Pediatric Dentistry Inc. | Dentist | 11600 Busy St Ste 101, North Chesterfield, VA 23236-4066 | 2020-02-04 |
| 1952963746 | Oula Kowatli | Dentist | 8255 Trailwood Ct, Vienna, VA 22182 | 2019-07-02 |
| 1770149742 | Noeen Arshad | Dentist | 129 University Blvd Ste A, Harrisonburg, VA 22801-3751 | 2019-05-15 |
| 1609353499 | Prachi Chandalia | Dentist | 609 E Monroe Ave, Alexandria, VA 22301-3020 | 2018-07-24 |
| 1255817730 | Fusion Dental | Dentist | 1401 Chain Bridge Rd, Mc Lean, VA 22101-6026 | 2018-07-17 |
| 1952897050 | Danielle Miller | Dentist | 11934 W Broad St Ste 120, Henrico, VA 23233-1100 | 2018-07-02 |
| 1063929057 | Anna Maria Boggs, Dmd, PC | Dentist | 1947 A Medical Ave, Harrisonburg, VA 22801 | 2017-12-29 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22192 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.