MEDICARE: TAJMINA T AKTER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DEN2000128	DC
2	122300000X	Dentist	0401417774	VA

General Provider Information

NPI Number	:	1003499245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAJMINA T AKTER DDS

Provider Business Mailing Address
First Line	:	950 HERNDON PKWY STE 140
Second Line	:
City	:	HERNDON
State	:	VA
Zip	:	20170-5526
Country	:	US
Telephone Number	:	703-393-9393
Fax Number	:

Provider Business Practice Location Address
First Line	:	10529 CRESTWOOD DR STE 103
Second Line	:
City	:	MANASSAS
State	:	VA
Zip	:	20109-4419
Country	:	US
Telephone Number	:	703-393-9393
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	10/18/2022

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Directions to “ TAJMINA T AKTER DDS” Practice Location

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