Healthcare Provider Details

I. General information

NPI: 1669848644
Provider Name (Legal Business Name): SKS DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2015
Last Update Date: 08/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 FAIRFAX DR SUITE 22
ARLINGTON VA
22203-1762
US

IV. Provider business mailing address

1309 SHAKER WOODS RD
HERNDON VA
20170-2611
US

V. Phone/Fax

Practice location:
  • Phone: 202-297-1336
  • Fax:
Mailing address:
  • Phone: 202-297-1336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401410990
License Number StateVA

VIII. Authorized Official

Name: DR. SMITA SABHARWAL
Title or Position: OWNER
Credential: DDS
Phone: 202-297-1336