Provider Demographics
NPI:1578187035
Name:KANCHAN SMILES INC
Entity type:Organization
Organization Name:KANCHAN SMILES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:V
Authorized Official - Last Name:KARANDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-688-5867
Mailing Address - Street 1:2063 JEFFERSON DAVIS HWY STE 1
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22554-7291
Mailing Address - Country:US
Mailing Address - Phone:540-659-7515
Mailing Address - Fax:
Practice Address - Street 1:2063 RICHMOND HWY STE 1
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-7291
Practice Address - Country:US
Practice Address - Phone:540-659-7515
Practice Address - Fax:540-720-2514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1578187035Medicaid