Provider Demographics
NPI:1407597669
Name:DRS. RUPARELIA & MUHAMMAD - CASCADES BURKE, PLLC
Entity Type:Organization
Organization Name:DRS. RUPARELIA & MUHAMMAD - CASCADES BURKE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:HENDRICKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-859-0444
Mailing Address - Street 1:6045 BURKE CENTRE PKWY STE 204
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-3751
Mailing Address - Country:US
Mailing Address - Phone:703-503-9490
Mailing Address - Fax:
Practice Address - Street 1:6045 BURKE CENTRE PKWY STE 204
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-3751
Practice Address - Country:US
Practice Address - Phone:703-503-9490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-03
Last Update Date:2022-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty