Provider Demographics
NPI:1609158674
Name:THUMAN, RENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:
Last Name:THUMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:RENA
Other - Middle Name:
Other - Last Name:VAKAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14245-F CENTREVILLE SQUARE
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121
Mailing Address - Country:US
Mailing Address - Phone:703-815-0775
Mailing Address - Fax:703-222-7557
Practice Address - Street 1:14245-F CENTREVILLE SQUARE
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121
Practice Address - Country:US
Practice Address - Phone:703-815-0775
Practice Address - Fax:703-222-7557
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006027122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist