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General NPI Number Information
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NPI Number | 1720349152
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Entity Type | Individual
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Provider Name | KHUSHBOO JAIN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/01/2012
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 2010 JOHN ROLFE PKWY
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City | RICHMOND
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State | VA
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Zip | 23238-8111
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Country | US
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Telephone | 804-750-1284
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Fax | 804-215-3905
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Provider Business Mailing Address
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Address Line | 2010 JOHN ROLFE PKWY
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City | RICHMOND
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State | VA
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Zip | 23238-8111
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Country | US
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Telephone | 804-750-1284
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Fax | 804-215-3905
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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 | 0401413582
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License Number State | VA
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