Russo Revand, Jessica
Russo Revand, Jessica is an sole proprietor health care provider with primary practice located at 4660 Kenmore Ave Suite 700, Alexandria VA 22304-1313. She recently has only one registered license in Dental Providers / Endodontics, which is considered as her primary health care specialty. Russo Revand, Jessica can be contacted via phone (703) 370-1327.Contact Information
Primary practice address
4660 Kenmore Ave Suite 700
Alexandria VA 22304-1313
Phone: (703) 370-1327
Fax: (703) 370-1907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 0401412509 | Virginia |
| Dental Providers / Endodontics | 1223E0200X | DEN1000827 | District of Columbia |
| Dental Providers / Endodontics | 1223E0200X | 51517 | California |
Profile Details
| NPI number | 1770712705 |
|---|---|
| LBN Legal business name | Russo Revand, Jessica |
| Credentials | DMD, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2009 |
| Last updated | Jul 13th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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