Provider Demographics
NPI:1083055404
Name:TAKIAR, VANI (DMD, MA)
Entity Type:Individual
Prefix:
First Name:VANI
Middle Name:
Last Name:TAKIAR
Suffix:
Gender:F
Credentials:DMD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 S KING ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-3907
Mailing Address - Country:US
Mailing Address - Phone:571-799-0559
Mailing Address - Fax:571-799-0560
Practice Address - Street 1:606 S KING ST STE 200
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20175-3907
Practice Address - Country:US
Practice Address - Phone:571-799-0559
Practice Address - Fax:571-799-0560
Is Sole Proprietor?:No
Enumeration Date:2013-07-14
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA04014143391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry