MEDICARE: SANGEETA KUMAR

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	1223P0700X	Prosthodontics	0401418588	VA

General Provider Information

NPI Number	:	1497535272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANGEETA KUMAR

Provider Business Mailing Address
First Line	:	2718 PEMBSLY DR
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22181-6157
Country	:	US
Telephone Number	:	202-413-9319
Fax Number	:

Provider Business Practice Location Address
First Line	:	21631 RIDGETOP CIR STE 240
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20166-4288
Country	:	US
Telephone Number	:	703-444-9900
Fax Number	:

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

Provider Enumeration Date	:	09/29/2023
Last Update Date	:	09/29/2023

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Directions to “ SANGEETA KUMAR ” Practice Location

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