Provider Demographics
NPI:1053466854
Name:KALANTAR, NEDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEDA
Middle Name:
Last Name:KALANTAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1984 ISAAC NEWTON SQ W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5038
Mailing Address - Country:US
Mailing Address - Phone:703-435-1500
Mailing Address - Fax:
Practice Address - Street 1:1984 ISAAC NEWTON SQ W
Practice Address - Street 2:SUITE 200
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5038
Practice Address - Country:US
Practice Address - Phone:703-435-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014105781223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry