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General NPI Number Information
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NPI Number | 1831671353
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Entity Type | Organization
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Legal Business Name | SACHIN RASTOGI DMD PLLC
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Dates
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Enumeration Date | 08/31/2018
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Last Update Date | 08/31/2018
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Provider Practice Location Address
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Address Line | 6116 ROLLING RD STE 304
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City | SPRINGFIELD
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State | VA
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Zip | 22152-1512
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Country | US
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Telephone | 571-310-1191
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 CLAMES DR
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2607
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Country | US
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Telephone | 781-354-7477
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SACHIN RASTOGI
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Credential | DMD
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Telephone | 571-310-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 0401415819
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License Number State | VA
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