Provider Demographics
NPI:1497353619
Name:NANDA, SHIKHA
Entity Type:Individual
Prefix:
First Name:SHIKHA
Middle Name:
Last Name:NANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25484 CARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-3961
Mailing Address - Country:US
Mailing Address - Phone:703-505-5231
Mailing Address - Fax:
Practice Address - Street 1:7501 LITTLE RIVER TPKE STE 201
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-2923
Practice Address - Country:US
Practice Address - Phone:703-256-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-09
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858859122300000X
VA0401417706122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist