Provider Demographics
NPI:1821423666
Name:MAHAJAN, ALKA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALKA
Middle Name:
Last Name:MAHAJAN
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 1:8301 ARLINGTON BLVD
Mailing Address - Street 2:SUITE T-2
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2902
Mailing Address - Country:US
Mailing Address - Phone:571-282-4226
Mailing Address - Fax:
Practice Address - Street 1:8301 ARLINGTON BLVD
Practice Address - Street 2:SUITE T-2
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2902
Practice Address - Country:US
Practice Address - Phone:571-282-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice