Healthcare Provider Details

I. General information

NPI: 1336769116
Provider Name (Legal Business Name): SANJAY I NARAINE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2020
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44340 PREMIER PLZ STE 100
ASHBURN VA
20147-5074
US

IV. Provider business mailing address

47337 ROCK FALLS TER
STERLING VA
20165-2433
US

V. Phone/Fax

Practice location:
  • Phone: 703-729-8700
  • Fax:
Mailing address:
  • Phone: 954-478-5706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number0404119955
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: