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NPI Code Detail

MEDICARE: SUJIT K MOHANTY DDS PC

MEDICARE: SUJIT K MOHANTY DDS PC
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
11223G0001XGeneral Practice Dentistry0401008745VA

General Provider Information

NPI Number : 1184095358
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUJIT K MOHANTY DDS PC
Provider Business Mailing Address
First Line : 1782 N PARHAM RD
Second Line :
City : RICHMOND
State : VA
Zip : 23229-4654
Country : US
Telephone Number : 804-527-1008
Fax Number : 804-527-0550
Provider Business Practice Location Address
First Line : 1782 N PARHAM RD
Second Line :
City : RICHMOND
State : VA
Zip : 23229-4654
Country : US
Telephone Number : 804-527-1008
Fax Number : 804-527-0550
Authorized Official
Title or Position : OWNER
Name : DR. SUJIT K MOHANTY
Credential : DDS
Telephone Number : 804-527-1008
Provider Enumeration Date : 10/14/2015
Last Update Date : 10/14/2015

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