Healthcare Provider Details

I. General information

NPI: 1528722477
Provider Name (Legal Business Name): YAMUNA DEVI SUBRAMANIAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YAMUNA DEVI SUBRAMANIAN DMD

II. Dates (important events)

Enumeration Date: 10/27/2021
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46519 LEESBURG PIKE STE 145
STERLING VA
20164-3577
US

IV. Provider business mailing address

109 POLLEN DR
LA PLATA MD
20646-3211
US

V. Phone/Fax

Practice location:
  • Phone: 571-496-0095
  • Fax: 346-509-6074
Mailing address:
  • Phone: 617-797-2710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401417648
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: