Provider Demographics
NPI:1285853564
Name:MURTHY, PRAMILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PRAMILA
Middle Name:
Last Name:MURTHY
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 1:1401 N TAFT ST
Mailing Address - Street 2:#1416
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2618
Mailing Address - Country:US
Mailing Address - Phone:703-999-5313
Mailing Address - Fax:
Practice Address - Street 1:1035 STERLING RD
Practice Address - Street 2:SUITE 204
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-3868
Practice Address - Country:US
Practice Address - Phone:703-471-8080
Practice Address - Fax:703-471-5354
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice