Healthcare Provider Details

I. General information

NPI: 1750082186
Provider Name (Legal Business Name): NEHA KWATRA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8955 WOODS ROAD BLDG 1, 4TH FLOOR RM 4393
BETHESDA MD
20889-5600
US

IV. Provider business mailing address

76 NEALY BLVD # 92
HAMPTON VA
23665-2022
US

V. Phone/Fax

Practice location:
  • Phone: 480-240-0753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD011786
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: