1942279591 NPI number — DR. VANDANA SOOD D.M.D.

Table of content: DR. VANDANA SOOD D.M.D. (NPI 1942279591)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942279591 NPI number — DR. VANDANA SOOD D.M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOOD
Provider First Name:
VANDANA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942279591
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19420 GOLF VISTA PLZ
Provider Second Line Business Mailing Address:
SUITE 360
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-8265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-723-9332
Provider Business Mailing Address Fax Number:
703-723-9336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19420 GOLF VISTA PLZ
Provider Second Line Business Practice Location Address:
SUITE 360
Provider Business Practice Location Address City Name:
LEESBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-8265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-723-9332
Provider Business Practice Location Address Fax Number:
703-723-9336
Provider Enumeration Date:
03/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  0401411405 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: VA200870 . This is a "GE CONSUMER FINANCE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 205256039-001 . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 6707-1 . This is a "DENTAL BENEFIT PROVIDERS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 115121 . This is a "UNITED CONCORDIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 309174 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 33838 . This is a "DOMINION DENTAL" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 91457 . This is a "DHA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 8580 . This is a "NORTHEAST DENTAL PLAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: DX178576 . This is a "DNOA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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