IndividualActive
Gene Vandervort, D.D.S./M.D.
NPI 1679548010 · Oral & Maxillofacial Surgery (D.M.D.) · Ashburn, VA
Provider details
- NPI number
- 1679548010
- Entity type
- Individual
- Primary specialty
- Oral & Maxillofacial Surgery (D.M.D.)Allopathic & Osteopathic Physicians
- Credential
- D.D.S./M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 0101102662 (VA)
Practice location
44340 Premier Plaza
Suite 100
Ashburn, VA 20147-5074
Phone: (703) 729-8700
Fax: (703) 729-5300
Mailing address
44340 Premier Plaza
Ashburn, VA 20147-5074
Registry dates
- Enumerated
- 2006-02-21
- Last updated
- 2009-07-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.