Provider Demographics
NPI:1629417654
Name:VEMARAJU, BINDU M (DDS)
Entity Type:Individual
Prefix:
First Name:BINDU
Middle Name:M
Last Name:VEMARAJU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 E PULASKI HWY STE 102
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6029
Mailing Address - Country:US
Mailing Address - Phone:410-202-0198
Mailing Address - Fax:
Practice Address - Street 1:25401 EASTERN MARKETPLACE PLZ
Practice Address - Street 2:SUITE 165
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-5782
Practice Address - Country:US
Practice Address - Phone:703-542-3171
Practice Address - Fax:703-542-7325
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163101223G0001X
VA0401414094122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice