MEDICARE: MOHIT CHAUDHARY D.D.S.

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	0401008665	VA

General Provider Information

NPI Number	:	1922173731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOHIT CHAUDHARY D.D.S.

Provider Business Mailing Address
First Line	:	5812 MAPLEDALE PLZ
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-4535
Country	:	US
Telephone Number	:	703-580-9900
Fax Number	:	703-580-0358

Provider Business Practice Location Address
First Line	:	5812 MAPLEDALE PLZ
Second Line	:
City	:	WOODBRIDGE
State	:	VA
Zip	:	22193-4535
Country	:	US
Telephone Number	:	703-580-9900
Fax Number	:	703-580-0358

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

Provider Enumeration Date	:	11/21/2006
Last Update Date	:	07/08/2007

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