Provider Demographics
NPI:1699010181
Name:DUBE, NEELAM JHAWAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEELAM
Middle Name:JHAWAR
Last Name:DUBE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NEELAM
Other - Middle Name:
Other - Last Name:JHAWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:112 ELDEN ST
Mailing Address - Street 2:SUITE N
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170-4874
Mailing Address - Country:US
Mailing Address - Phone:703-787-9000
Mailing Address - Fax:703-787-8557
Practice Address - Street 1:112 ELDEN ST
Practice Address - Street 2:SUITE N
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4874
Practice Address - Country:US
Practice Address - Phone:703-787-9000
Practice Address - Fax:703-787-8557
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014138231223G0001X
MD153141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice