Provider Demographics
NPI:1609353499
Name:CHANDALIA, PRACHI (DMD)
Entity Type:Individual
Prefix:DR
First Name:PRACHI
Middle Name:
Last Name:CHANDALIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3299 K ST NW APT 702
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4450
Mailing Address - Country:US
Mailing Address - Phone:202-322-3392
Mailing Address - Fax:
Practice Address - Street 1:609 E MONROE AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22301-3020
Practice Address - Country:US
Practice Address - Phone:703-341-4418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014161771223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry