Provider Demographics
NPI:1871994426
Name:DHAM, ADITI KIRPAL (DMD)
Entity type:Individual
Prefix:DR
First Name:ADITI KIRPAL
Middle Name:
Last Name:DHAM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ADITI KIRPAL
Other - Middle Name:
Other - Last Name:DHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:13203 FRANKLIN VIEW CT
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1129
Mailing Address - Country:US
Mailing Address - Phone:240-342-0421
Mailing Address - Fax:
Practice Address - Street 1:13203 FRANKLIN VIEW CT
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1129
Practice Address - Country:US
Practice Address - Phone:240-342-0421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-12
Last Update Date:2020-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014154061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty