Provider Demographics
NPI:1922237346
Name:ULLRICH, COURTNEY J (DMD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:J
Last Name:ULLRICH
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 1:21785 FILIGREE CT STE 208
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6214
Mailing Address - Country:US
Mailing Address - Phone:703-729-7005
Mailing Address - Fax:703-729-5799
Practice Address - Street 1:21785 FILIGREE CT
Practice Address - Street 2:SUITE # 208
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6213
Practice Address - Country:US
Practice Address - Phone:703-729-7005
Practice Address - Fax:703-729-5799
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014125211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics