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General NPI Number Information
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NPI Number | 1457512188
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Entity Type | Organization
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Legal Business Name | DEEPAK KAKAR DDS
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Dates
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Enumeration Date | 06/25/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 927 MAPLE GROVE DR SUITE 111
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-6936
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Country | US
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Telephone | 540-786-0051
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Fax | 540-786-0999
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Provider Business Mailing Address
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Address Line | 927 MAPLE GROVE DR SUITE 111
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-6936
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Country | US
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Telephone | 540-786-0051
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Fax | 540-786-0999
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. HEATHER LYNNE SPEAR-VENTRE
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Credential |
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Telephone | 540-786-0051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401410972
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 0401410573
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License Number State | VA
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