Provider Demographics
NPI:1659197770
Name:JOO, DIANA H (DDS)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:H
Last Name:JOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HEE
Other - Middle Name:RYANG
Other - Last Name:JOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8304 GREENTREE MANOR LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX STATION
Mailing Address - State:VA
Mailing Address - Zip Code:22039-3214
Mailing Address - Country:US
Mailing Address - Phone:703-309-7116
Mailing Address - Fax:
Practice Address - Street 1:5500 COLUMBIA PIKE STE B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-5867
Practice Address - Country:US
Practice Address - Phone:703-575-9899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014193741223P0700X
PADS0449891223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics