Healthcare Provider Details

I. General information

NPI: 1285096818
Provider Name (Legal Business Name): SALINI SREE HOTA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24430 STONES SPRINGS BLVD, SUITE 215
DULLES VA
20166-2268
US

IV. Provider business mailing address

224-D CORNWALL STREET, NW. SUITE 403
LEESBURG VA
20176-3098
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-3200
  • Fax: 703-858-3203
Mailing address:
  • Phone: 703-737-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number316429-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101279086
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: