Provider Demographics
NPI:1376787283
Name:JAVEED, ASRA R (DMD)
Entity Type:Individual
Prefix:
First Name:ASRA
Middle Name:R
Last Name:JAVEED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 BELDOVER CT
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-5923
Mailing Address - Country:US
Mailing Address - Phone:347-647-1058
Mailing Address - Fax:
Practice Address - Street 1:2142 GREAT NECK SQ
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2202
Practice Address - Country:US
Practice Address - Phone:757-481-3699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412422122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist