Provider Demographics
NPI:1194258095
Name:GANESH, RASHMI
Entity type:Individual
Prefix:
First Name:RASHMI
Middle Name:
Last Name:GANESH
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 1:23371 BYMES MILL TER
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-8112
Mailing Address - Country:US
Mailing Address - Phone:716-380-3075
Mailing Address - Fax:
Practice Address - Street 1:23371 BYMES MILL TER
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20148-8112
Practice Address - Country:US
Practice Address - Phone:716-380-3075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014155381223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics