Provider Demographics
NPI:1326861790
Name:ANKITA JAIN DDS, PLLC
Entity type:Organization
Organization Name:ANKITA JAIN DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANKITA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:631-327-7323
Mailing Address - Street 1:17115 BELLE ISLE DR
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-3004
Mailing Address - Country:US
Mailing Address - Phone:631-327-7323
Mailing Address - Fax:
Practice Address - Street 1:1300 THORNTON ST STE 101
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4654
Practice Address - Country:US
Practice Address - Phone:540-371-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-05
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty