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Contact Information

LEGACY DENTAL IMPLANT
3000 10TH ST N
ARLINGTON, VA22201-2162
 Phone: 646-824-3829
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Periodontics

1223P0300X
 

Dentist

122300000X
 

Endodontics

1223E0200X
 

Orthodontics and Dentofacial Orthopedics

1223X0400X
Indicates primary specialty

NPI Profile & details for LEGACY DENTAL IMPLANT

NPI Number 1356186654
LBN Legal business name LEGACY DENTAL IMPLANT
Authorized official AHMED MATRI - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/27/2024
Last updated 06/27/2024 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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