Provider Demographics
NPI:1730925512
Name:MALDONADO SARMIENTO, ANA PAOLA
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:PAOLA
Last Name:MALDONADO SARMIENTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SHALLOW CREEK DR
Mailing Address - Street 2:
Mailing Address - City:RANSON
Mailing Address - State:WV
Mailing Address - Zip Code:25438-4038
Mailing Address - Country:US
Mailing Address - Phone:240-883-4596
Mailing Address - Fax:
Practice Address - Street 1:1681 S PLEASANT VALLEY RD
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-4484
Practice Address - Country:US
Practice Address - Phone:540-678-7097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-02
Last Update Date:2025-08-11
Deactivation Date:2025-07-10
Deactivation Code:
Reactivation Date:2025-08-09
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0401419609122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program