Provider Demographics
NPI:1891991725
Name:KWATRA, NAVEEN (DDS)
Entity type:Individual
Prefix:DR
First Name:NAVEEN
Middle Name:
Last Name:KWATRA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5280 MEADOW ESTATES DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6658
Mailing Address - Country:US
Mailing Address - Phone:703-725-9079
Mailing Address - Fax:
Practice Address - Street 1:806 W DIAMOND AVE STE 250
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1462
Practice Address - Country:US
Practice Address - Phone:301-977-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142391223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry