Provider Demographics
NPI:1114007291
Name:CHARAIPOTRA, NEIL HANS (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEIL
Middle Name:HANS
Last Name:CHARAIPOTRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6116 ROLLING RD
Mailing Address - Street 2:SUITE 316
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1521
Mailing Address - Country:US
Mailing Address - Phone:703-451-8332
Mailing Address - Fax:703-451-4661
Practice Address - Street 1:6116 ROLLING RD
Practice Address - Street 2:SUITE 316
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1521
Practice Address - Country:US
Practice Address - Phone:703-451-8332
Practice Address - Fax:703-451-4661
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA100761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA792905OtherUNITED CONCORDIA GROUP #