MEDICARE: DR. ADITYA DHAKAR 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	1223G0001X	General Practice Dentistry	0401413364	VA

General Provider Information

NPI Number	:	1932481439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADITYA DHAKAR DDS

Provider Business Mailing Address
First Line	:	4440 SPRINGFIELD RD
Second Line	:	SUITE 101
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3410
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4440 SPRINGFIELD RD
Second Line	:	SUITE 101
City	:	GLEN ALLEN
State	:	VA
Zip	:	23060-3410
Country	:	US
Telephone Number	:	804-217-9820
Fax Number	:

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

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	02/21/2013

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