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

VA Southern Dental PPO PC

Organization Dentist · NPI 1508718750

VA Southern Dental PPO PC is a Dentist in Annandale, Virginia. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4330 Evergreen Ln Ste F1
Annandale, VA 22003-3258
Phone: (703) 941-2763
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X

Record details

NPI number1508718750
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationVA Southern Dental PPO PC
Authorized official Erika Menjivar — Sr. Credentialing Specialist · (469) 596-6137
Other names Yen Le Dds
NPI enumeratedFebruary 11, 2026
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026
Mailing address5830 Granite Pkwy Ste 780, Plano, TX 75024-6775

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