Provider Demographics
NPI:1841587664
Name:PERUMAL NAIDU NAGAIAH, ROHINI (DDS)
Entity Type:Individual
Prefix:
First Name:ROHINI
Middle Name:
Last Name:PERUMAL NAIDU NAGAIAH
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 1:2407 COLUMBIA PIKE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22204-4469
Mailing Address - Country:US
Mailing Address - Phone:571-312-4111
Mailing Address - Fax:
Practice Address - Street 1:2407 COLUMBIA PIKE
Practice Address - Street 2:SUITE 280
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22204-4469
Practice Address - Country:US
Practice Address - Phone:571-312-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2014-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL111461223G0001X
VA04014139641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice