Provider Demographics
NPI:1528264959
Name:BRINDA DIXIT INC
Entity type:Organization
Organization Name:BRINDA DIXIT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DIXIT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-277-9927
Mailing Address - Street 1:516 INNOVATION DR STE 204
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3866
Mailing Address - Country:US
Mailing Address - Phone:757-277-9927
Mailing Address - Fax:757-277-9928
Practice Address - Street 1:516 INNOVATION DR STE 204
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3866
Practice Address - Country:US
Practice Address - Phone:757-277-9927
Practice Address - Fax:757-277-9928
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRINDA DIXIT INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-22
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235009174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010296650Medicaid
VAC09697Medicare ID - Type UnspecifiedGROUP NUMBER
VA010296650Medicaid