Provider Demographics
NPI:1023305992
Name:APANA, ALESIA (DMD)
Entity type:Individual
Prefix:
First Name:ALESIA
Middle Name:
Last Name:APANA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 N HIGHLAND ST APT 411
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-7062
Mailing Address - Country:US
Mailing Address - Phone:954-695-9191
Mailing Address - Fax:
Practice Address - Street 1:1145 19TH ST NW STE 512
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3715
Practice Address - Country:US
Practice Address - Phone:202-331-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 193171223G0001X
DCDEN1001281122300000X
VA0401414046122300000X
MD15495122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006256900Medicaid