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General NPI Number Information
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NPI Number | 1790910859
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Entity Type | Individual
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Provider Name | DR. ARCHANA R REJINTALA
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Gender | Female
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 24805 PINEBROOK RD STE 212
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City | SOUTH RIDING
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State | VA
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Zip | 20152-4128
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Country | US
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Telephone | 904-566-6549
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Fax |
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Provider Business Mailing Address
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Address Line | 41646 BOSTONIAN PL
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City | ALDIE
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State | VA
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Zip | 20105-5648
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Country | US
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Telephone | 904-566-6549
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 0401412664
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License Number State | VA
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