Provider Demographics
NPI:1790032076
Name:VAKHARIA, JAINY D (DDS)
Entity Type:Individual
Prefix:
First Name:JAINY
Middle Name:D
Last Name:VAKHARIA
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 1:14316 SUMMER TREE RD APT I
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-4017
Mailing Address - Country:US
Mailing Address - Phone:201-757-4312
Mailing Address - Fax:
Practice Address - Street 1:13922 ESTATE MANOR DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-5951
Practice Address - Country:US
Practice Address - Phone:703-754-7788
Practice Address - Fax:703-754-7788
Is Sole Proprietor?:No
Enumeration Date:2012-08-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA62515122300000X
NV63061223G0001X
VA04014152561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist