Provider Demographics
NPI:1962190025
Name:VAMA LLC
Entity type:Organization
Organization Name:VAMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BADDAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:217-414-4234
Mailing Address - Street 1:11500 COMMERCE PARK DR APT 440
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1176
Mailing Address - Country:US
Mailing Address - Phone:217-414-4234
Mailing Address - Fax:
Practice Address - Street 1:9093 RIDGEFIELD DR STE 203
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6712
Practice Address - Country:US
Practice Address - Phone:217-414-4234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-26
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty