=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962758912
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PREETHI NAIR DMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/27/2012
-----------------------------------------------------
Last Update Date | 02/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 700 INDEPENDENCE CIR SUITE #1D
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 757-392-7351
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 700 INDEPENDENCE CIR SUITE #1D
-----------------------------------------------------
City | VIRGINIA BEACH
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 23455
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-420-4521
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223P0221X
-----------------------------------------------------
Taxonomy Name | Pediatric Dentistry
-----------------------------------------------------
License Number | 0401416990
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------