Provider Demographics
NPI:1881360196
Name:DALSANIA, ARJUN A
Entity type:Individual
Prefix:
First Name:ARJUN
Middle Name:A
Last Name:DALSANIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14212 SMOKETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4708
Mailing Address - Country:US
Mailing Address - Phone:860-518-5229
Mailing Address - Fax:
Practice Address - Street 1:14212 SMOKETOWN RD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4708
Practice Address - Country:US
Practice Address - Phone:703-878-2020
Practice Address - Fax:571-285-1143
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-17
Last Update Date:2024-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003803152W00000X
DCOP2000529152W00000X
MDTA2887152W00000X
VA06180003280152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist