Healthcare Provider Details

I. General information

NPI: 1992906168
Provider Name (Legal Business Name): VEDIC DENTAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 DARNESTOWN RD STE H2
GAITHERSBURG MD
20878-2602
US

IV. Provider business mailing address

10810 DARNESTOWN RD STE H2
GAITHERSBURG MD
20878-2602
US

V. Phone/Fax

Practice location:
  • Phone: 301-738-1074
  • Fax:
Mailing address:
  • Phone: 301-738-1074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number13983
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. KALPNA RANADIVE
Title or Position: DENTIST
Credential: DMD
Phone: 301-738-1074