Provider Demographics
NPI:1336870393
Name:SMITH, VEDA JANEL (OD)
Entity type:Individual
Prefix:DR
First Name:VEDA
Middle Name:JANEL
Last Name:SMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:VEDA
Other - Middle Name:JANEL
Other - Last Name:MAGAGNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:8614 WESTWOOD CENTER DR FL 9
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2442
Mailing Address - Country:US
Mailing Address - Phone:703-847-8899
Mailing Address - Fax:571-223-6780
Practice Address - Street 1:6120 FIRESTONE BLVD UNIT 403
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-6475
Practice Address - Country:US
Practice Address - Phone:720-966-2020
Practice Address - Fax:720-966-2021
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0003791152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist