Provider Demographics
NPI:1194034785
Name:DEEPAK S KAKAR DDS INC
Entity Type:Organization
Organization Name:DEEPAK S KAKAR DDS INC
Other - Org Name:TYSONS PEDIATRIC DENTISTRY AND ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMY
Authorized Official - Middle Name:E
Authorized Official - Last Name:STYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-786-0051
Mailing Address - Street 1:7115 LEESBURG PIKE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-2367
Mailing Address - Country:US
Mailing Address - Phone:703-534-1611
Mailing Address - Fax:
Practice Address - Street 1:7115 LEESBURG PIKE
Practice Address - Street 2:SUITE 210
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2367
Practice Address - Country:US
Practice Address - Phone:703-534-1611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014122521223G0001X
VA04014105731223P0221X
VA04010070261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA155850911OtherNPI DR ZUKAEY AL-LABABIDI
VA1174626717OtherPROVIDER NPI NUMBER
VA1710081195OtherNPI NUMBER DR RICHARD BYRD