Provider Demographics
NPI:1174016190
Name:CHAUDHRY, BILAL RASOOL (DDS)
Entity Type:Individual
Prefix:
First Name:BILAL
Middle Name:RASOOL
Last Name:CHAUDHRY
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 1:6717 SWINDON PL
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20112-5569
Mailing Address - Country:US
Mailing Address - Phone:703-608-0594
Mailing Address - Fax:
Practice Address - Street 1:801 N QUINCY ST STE 110
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203
Practice Address - Country:US
Practice Address - Phone:703-778-7610
Practice Address - Fax:703-243-8006
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014160591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice