| Lake Ridge Vision Center Inc. | |
|
12444 Dillingham Sq, Woodbridge, VA 22192-5258 | |
| (703) 680-4323 | |
| (703) 680-4358 |
| Full Name | Lake Ridge Vision Center Inc. |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 12444 Dillingham Sq, Woodbridge, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285807404 | NPI | - | NPPES |
| CO2323 | Other | VA | PTAN |
| 5383-0000 | Other | VA | CARE FIRST BCBS |
| 1729424 | Other | VA | AETNA HMO |
| 343378 | Other | VA | ANTHEM BLUE CROSS BLUE SH |
| 5946431 | Other | VA | AETNA PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (* (Not Available)) | Primary |
| Provider Name | Richard A Jablonski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295796712 PECOS PAC ID: 0446358642 Enrollment ID: I20070612000658 |
| Provider Name | Diane M Conness |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1578524096 PECOS PAC ID: 0446326656 Enrollment ID: I20080911000242 |
| Provider Name | Adrian Al-damari |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841606472 PECOS PAC ID: 6406178771 Enrollment ID: I20141124001468 |
| Provider Name | Alicia E Kim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922415306 PECOS PAC ID: 5890913651 Enrollment ID: I20151208001873 |
| Provider Name | Julia E Pierce |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811425705 PECOS PAC ID: 0749552529 Enrollment ID: I20170815002145 |
| Provider Name | Obaidullah Faiq |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417441023 PECOS PAC ID: 6507116993 Enrollment ID: I20180905003394 |
| Provider Name | Yeseul Lim |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1841883212 PECOS PAC ID: 5496161531 Enrollment ID: I20210315002431 |
| Provider Name | Alan Van |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356014773 PECOS PAC ID: 7315343621 Enrollment ID: I20210913001959 |
| Mailing Address | Practice Location Address |
|---|---|
| Lake Ridge Vision Center Inc. 12444 Dillingham Sq, Woodbridge, VA 22192-5258 Ph: (703) 680-4323 | Lake Ridge Vision Center Inc. 12444 Dillingham Sq, Woodbridge, VA 22192-5258 Ph: (703) 680-4323 |
Dr. Russell Hale Mattern, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2700 Potomac Mills Cir, Suite 207, Woodbridge, VA 22192 Phone: 703-490-5275 | |
Dr. Herbert Norman Furst, OD Optometrist Medicare: Medicare Enrolled Practice Location: 14139 Potomac Mills Road, Woodbridge, VA 20192 Phone: 703-490-7606 Fax: 703-490-7824 | |
Dr. Nancy Jane Graves, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 3102 Golansky Blvd, Ste 101, Woodbridge, VA 22192 Phone: 703-590-2888 Fax: 703-590-1121 | |
Walton Rice, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2700 Potomac Mills Cir Ste 105, Woodbridge, VA 22192 Phone: 703-494-0660 Fax: 703-497-4605 | |
Dr. Jerry J Deola, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 4460 Dale Blvd, Woodbridge, VA 22193 Phone: 703-670-8085 | |
Dr. David L Mcnerney, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1714 Financial Loop, Woodbridge, VA 22192 Phone: 703-494-7721 Fax: 703-494-4617 | |
Aaron Figler, O.d., & Associates, P.c. Optometrist Medicare: Medicare Enrolled Practice Location: 14904 Jefferson Davis Hwy, Ste 308, Woodbridge, VA 22191 Phone: 703-494-3937 |