Provider Demographics
NPI:1508001314
Name:SAXENA DENTAL INC
Entity Type:Organization
Organization Name:SAXENA DENTAL INC
Other - Org Name:DBA ELITE SMILES DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.E.O
Authorized Official - Prefix:DR
Authorized Official - First Name:CHETANA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SAXENA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-771-9494
Mailing Address - Street 1:552 FORT EVANS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-4098
Mailing Address - Country:US
Mailing Address - Phone:703-771-9494
Mailing Address - Fax:
Practice Address - Street 1:552 FORT EVANS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-4098
Practice Address - Country:US
Practice Address - Phone:703-771-9494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410456261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental