Provider Demographics
NPI:1437340163
Name:VANDANA SOOD, D.M.D., LLC
Entity Type:Organization
Organization Name:VANDANA SOOD, D.M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VANDANA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-723-9332
Mailing Address - Street 1:19420 GOLF VISTA PLZ
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8265
Mailing Address - Country:US
Mailing Address - Phone:703-723-9332
Mailing Address - Fax:703-723-9336
Practice Address - Street 1:19420 GOLF VISTA PLZ
Practice Address - Street 2:SUITE 360
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8265
Practice Address - Country:US
Practice Address - Phone:703-723-9332
Practice Address - Fax:703-723-9336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-07
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014114051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA115121OtherUNITED CONCORDIA
VA6707-1OtherDENTAL BENEFIT PROVIDERS
VAVA200870OtherGE CONSUMER FINANCE
VA309174OtherANTHEM
VA92697OtherDHA
VADX178576OtherDNOA
VA33838OtherDOMINION DENTAL
VA8580OtherNORTHEAST DENTAL PLAN
VA92697OtherDHA