Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401414759 | VA |
NPI | 1003240276 |
---|---|
Provider Name | Dr. Charanpreet Ashtakala |
First Address | Arlington, VA 22203-2452 |
Second Address | Arlington, VA 22203-2452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2013 |
Last Update Date | 17/03/2018 |