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General NPI Number Information
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NPI Number | 1609178847
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Entity Type | Individual
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Provider Name | DEEPA SURYANARAYANAN DMD
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Gender | Female
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Dates
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Enumeration Date | 11/20/2010
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 6525 BELCREST RD STE 212
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City | HYATTSVILLE
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State | MD
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Zip | 20782-2062
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Country | US
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Telephone | 301-927-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 801 15TH ST S APT 1004
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City | ARLINGTON
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State | VA
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Zip | 22202-5020
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Country | US
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Telephone | 571-265-3969
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 14792
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401413027
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License Number State | VA
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