Provider Demographics
NPI:1922257617
Name:HYDER, KHUDSIA M (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHUDSIA
Middle Name:M
Last Name:HYDER
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 1:2416 STERLINGWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233-2233
Mailing Address - Country:US
Mailing Address - Phone:804-201-0688
Mailing Address - Fax:
Practice Address - Street 1:2416 STERLINGWOOD TRCE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233-2233
Practice Address - Country:US
Practice Address - Phone:804-201-0688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014122861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice