Healthcare Provider Details

I. General information

NPI: 1548478712
Provider Name (Legal Business Name): RINKU MEHRA SANDESARA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RINKU MEHRA MD

II. Dates (important events)

Enumeration Date: 05/19/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8229 BOONE BLVD STE 760
VIENNA VA
22182-2635
US

IV. Provider business mailing address

8229 BOONE BLVD STE 760
VIENNA VA
22182-2635
US

V. Phone/Fax

Practice location:
  • Phone: 703-940-0635
  • Fax: 844-670-9161
Mailing address:
  • Phone: 703-940-0635
  • Fax: 844-670-9161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35623
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number0101243156
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberD0067447
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberMD037198
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: