Provider Demographics
NPI:1063524684
Name:KHARA, AMANJOT (DDS)
Entity type:Individual
Prefix:
First Name:AMANJOT
Middle Name:
Last Name:KHARA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6372 MECHANICSVILLE TURNPIKE
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111
Mailing Address - Country:US
Mailing Address - Phone:804-559-5808
Mailing Address - Fax:804-559-9671
Practice Address - Street 1:6372 MECHANICSVILLE TURNPIKE
Practice Address - Street 2:SUITE 106
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-7100
Practice Address - Country:US
Practice Address - Phone:804-559-5808
Practice Address - Fax:804-559-9671
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010086521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice