Provider Demographics
NPI:1770912560
Name:NATASHA KHURANA DDS PLLC
Entity type:Organization
Organization Name:NATASHA KHURANA DDS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER, PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:571-248-1501
Mailing Address - Street 1:7915 LAKE MANASSAS DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3258
Mailing Address - Country:US
Mailing Address - Phone:571-248-1501
Mailing Address - Fax:703-563-9237
Practice Address - Street 1:7915 LAKE MANASSAS DR
Practice Address - Street 2:SUITE 301
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3258
Practice Address - Country:US
Practice Address - Phone:571-248-1501
Practice Address - Fax:703-563-9237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014124611223X0400X
VA04014134361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty