Provider Demographics
NPI:1902477482
Name:JB DENTAL ASSOCIATES AND TMD SLEEP CENTER, PLLC
Entity Type:Organization
Organization Name:JB DENTAL ASSOCIATES AND TMD SLEEP CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:BAHNG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-444-4188
Mailing Address - Street 1:46161 WESTLAKE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:703-444-4188
Mailing Address - Fax:
Practice Address - Street 1:46161 WESTLAKE DR STE 310
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:703-444-4188
Practice Address - Fax:703-444-4309
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-07
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty