Provider Demographics
NPI:1134286909
Name:ANAND, VISHAL (DDS)
Entity type:Individual
Prefix:DR
First Name:VISHAL
Middle Name:
Last Name:ANAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10500 WAKEMAN DR STE 400
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-8012
Mailing Address - Country:US
Mailing Address - Phone:540-891-2960
Mailing Address - Fax:
Practice Address - Street 1:10500 WAKEMAN DR STE 400
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8012
Practice Address - Country:US
Practice Address - Phone:540-891-2960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice