Provider Demographics
NPI:1659942365
Name:NAIK, SIMONA (DMD)
Entity Type:Individual
Prefix:
First Name:SIMONA
Middle Name:
Last Name:NAIK
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 1:502 SUNSET VIEW TER SE UNIT 304
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20175-6174
Mailing Address - Country:US
Mailing Address - Phone:781-627-6048
Mailing Address - Fax:
Practice Address - Street 1:3065 CENTREVILLE RD UNIT A
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20171-3717
Practice Address - Country:US
Practice Address - Phone:703-437-0333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-03
Last Update Date:2021-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417485122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist