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General NPI Number Information
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NPI Number | 1881360196
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Entity Type | Individual
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Provider Name | ARJUN A DALSANIA
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Gender | Male
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 02/18/2024
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Provider Practice Location Address
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Address Line | 14212 SMOKETOWN RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4708
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Country | US
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Telephone | 703-878-2020
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Fax | 571-285-1143
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Provider Business Mailing Address
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Address Line | 14212 SMOKETOWN RD
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City | WOODBRIDGE
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State | VA
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Zip | 22192-4708
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Country | US
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Telephone | 860-518-5229
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OEG003803
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP2000529
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA2887
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 06180003280
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License Number State | VA
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