MEDICARE: DR. NATASHA KHURANA DDS, IBCLC

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	122300000X	Dentist	22DI02365700	NJ
2	1223P0221X	Pediatric Dentistry	26138	TX
3	1223P0221X	Pediatric Dentistry	0401413436	VA
4	1223P0221X	Pediatric Dentistry	6000	LA
5	1223P0221X	Pediatric Dentistry	14857	MD

General Provider Information

NPI Number	:	1669648028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATASHA KHURANA DDS, IBCLC

Provider Business Mailing Address
First Line	:	7627 CODDLE HARBOR LN
Second Line	:
City	:	POTOMAC
State	:	MD
Zip	:	20854-3200
Country	:	US
Telephone Number	:	240-305-5552
Fax Number	:

Provider Business Practice Location Address
First Line	:	7915 LAKE MANASSAS DRIVE
Second Line	:	SUITE 301
City	:	GAINESVILLE
State	:	VA
Zip	:	20155-3258
Country	:	US
Telephone Number	:	703-743-5937
Fax Number	:	703-563-9237

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

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	07/22/2019

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