Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lakeridge Dental Associates

Organization Preferred Provider Organization · NPI 1902210776

Lakeridge Dental Associates is a Preferred Provider Organization in Woodbridge, Virginia. Licensed in Virginia. Registered with an NPI since 2014.

Licensed in
VA
In the registry since
2014
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Practice location Address checks out

12506 Lake Ridge Dr
Woodbridge, VA 22192-2397
Phone: (571) 408-4459
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X · Licence 0401008767 (VA)

Record details

NPI number1902210776
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sasan Ahmadiyar — Dentist/Owner · (540) 710-6000
NPI enumeratedJune 19, 2014
Last updated in NPPESJune 19, 2014
Mailing address12506 Lake Ridge Dr, Woodbridge, VA 22192-2397

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