MEDICARE: TANYA JADHAV

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	0401416888	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639660699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANYA JADHAV

Provider Business Mailing Address
First Line	:	6120 ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2901
Country	:	US
Telephone Number	:	571-385-0162
Fax Number	:

Provider Business Practice Location Address
First Line	:	6120 ARLINGTON BLVD
Second Line	:
City	:	FALLS CHURCH
State	:	VA
Zip	:	22044-2901
Country	:	US
Telephone Number	:	571-385-0162
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2018
Last Update Date	:	12/05/2025

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Directions to “ TANYA JADHAV ” Practice Location

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