Provider Demographics
NPI:1942279591
Name:SOOD, VANDANA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VANDANA
Middle Name:
Last Name:SOOD
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 1:19420 GOLF VISTA PLZ
Mailing Address - Street 2:SUITE 360
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8265
Mailing Address - Country:US
Mailing Address - Phone:703-723-9332
Mailing Address - Fax:703-723-9336
Practice Address - Street 1:19420 GOLF VISTA PLZ
Practice Address - Street 2:SUITE 360
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8265
Practice Address - Country:US
Practice Address - Phone:703-723-9332
Practice Address - Fax:703-723-9336
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014114051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA200870OtherGE CONSUMER FINANCE
VA205256039-001OtherCAREFIRST BC/BS
VA6707-1OtherDENTAL BENEFIT PROVIDERS
VA115121OtherUNITED CONCORDIA
VA309174OtherANTHEM
VA33838OtherDOMINION DENTAL
VA91457OtherDHA
VA8580OtherNORTHEAST DENTAL PLAN
VADX178576OtherDNOA