DR. DATTATHRI B MALYAVANTHAM (NPI# 1811902224) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811902224 |
| Entity Type | Individual |
| Full Name | DR. DATTATHRI B MALYAVANTHAM |
| Credential | DDS |
| Practice Address |
21475 Ridgetop Cir Suite 230 Sterling VA 20166-6580 |
| Practice Telephone | 7034449900 |
| Mailing Telephone | 7034449900 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
00401410653 | VA | Dental Providers |
| Street Address |
21475 RIDGETOP CIR SUITE 230 |
| City | STERLING |
| State | VA |
| Zip Code | 20166-6580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407837727 | Ivey G Peterson | Physician Assistant | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2005-11-14 |
| 1255880852 | Roshan Patel | Physical Therapist | 21475 Ridgetop Cir, Sterling, VA 20166-6580 | 2016-09-25 |
| 1023499522 | Casey Lynn Baumgardner | Physician Assistant | 21475 Ridgetop Cir, Ste150, Sterling, VA 20166-6580 | 2015-06-11 |
| 1760879902 | Loudoun Medical Group PC | Ophthalmology | 21475 Ridgetop Cir, Suite 300, Sterling, VA 20166-6580 | 2015-04-24 |
| 1982019105 | Cory Edward Kraftson | Physician Assistant | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2014-06-26 |
| 1780096479 | Tatiana Staver | Dentist | 21475 Ridgetop Cir, Suite 200, Sterling, VA 20166-6580 | 2014-05-29 |
| 1871936765 | Erin Holland | Occupational Therapist | 21475 Ridgetop Cir, Suite 260, Sterling, VA 20166-6580 | 2013-04-10 |
| 1548523533 | David Saul Levine | Orthopaedic Surgery | 21475 Ridgetop Cir, Ste 150, Sterling, VA 20166-8521 | 2012-06-25 |
| 1457612301 | Deanna Busteed | Dietitian, Registered | 21475 Ridgetop Cir, Suite 150, Sterling, VA 20166-6580 | 2012-06-06 |
| 1225303704 | Diana Vartui Sensenbrenner | Dentist | 21475 Ridgetop Cir, Suite Number 230, Sterling, VA 20166-6580 | 2012-03-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881187458 | Vincent Seng | Behavior Technician | 4040 Center Oak Plaza, Suite 150, Sterling, VA 20166 | 2018-06-08 |
| 1205339348 | Morgan Elyse Gillum | Occupational Therapist | 45305 Catalina Ct Ste 101, Sterling, VA 20166 | 2018-03-15 |
| 1376090548 | Chelsea Moore | Behavioral Analyst | 46040 Center Oak Plz Ste 150, Sterling, VA 20166 | 2016-09-06 |
| 1194175711 | Krisha Verma | Dentist | 21631 Ridgetop Cir Ste 240, Sterling, VA 20166 | 2016-06-14 |
| 1265898571 | Bba Home Health Care | Home Health | 23420 Summerstown Place, Dulles, VA 20166 | 2016-01-04 |
| 1588038590 | Mancy Modi | Physical Therapist | 45305 Catalina Court, Suite 103, Sterling, VA 20166 | 2015-11-16 |
| 1912300377 | Kiley Coleman Gibbs | Physical Therapist | 21631 Ridgetop Cir Ste 225a, Sterling, VA 20166 | 2014-09-30 |
| 1053712554 | Rx Ante Pharmacy Services, LLC | Pharmacy | 21630 Ridgetop Circle, Suite 100, Sterling, VA 20166 | 2014-09-16 |
| 1972904738 | Northern Virginia Community Hospital LLC | General Acute Care Hospital | 24440 Stone Springs Boulevard, Dulles, VA 20166 | 2014-09-11 |
| 1518304641 | Institute for The Psychological Sciences | Psychologist | 45154 Underwood Ln., Sterling, VA 20166 | 2013-05-30 |
| Find all providers in zip 20166 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346740453 | Carolyn Seraphin Jones | Dentist | 2 Pidgeon Hill Dr Ste 230, Sterling, VA 20165-6148 | 2018-02-15 |
| 1043736473 | Miranda Foster | Dentist | 415 Locus St, Ste A, Sterling, IL 61081 | 2017-08-17 |
| 1477074623 | Alan Andrews | Dentist | 1408 S 3rd Ave, Sterling, CO 80751-4650 | 2017-06-28 |
| 1790214245 | Brian Vu | Dentist | 21155 Whitfield Pl Ste 101, Sterling, VA 20165-7277 | 2017-06-08 |
| 1194175711 | Krisha Verma | Dentist | 21631 Ridgetop Cir Ste 240, Sterling, VA 20166 | 2016-06-14 |
| 1629457767 | Kiarash Saba | Dentist | 47640 Paulsen Sq, Sterling, VA 20165-5193 | 2015-05-21 |
| 1730503970 | Roja Vemula | Dentist | 107 E Holly Ave Ste 5, Sterling, VA 20164-5405 | 2014-02-07 |
| 1003257239 | Brian J Chase | Dentist | 21435 Epicerie Plz Ste 190, Sterling, VA 20164-6641 | 2013-07-16 |
| 1255613105 | Truc Duong D.d.s., P.c | Dentist | 21145 Whitfield Pl Ste 103, Sterling, VA 20165-7278 | 2011-09-16 |
| 1982882585 | Alfred Franz Haeberer IIi | Dentist | 21145 Whitfield Place, Unit 102, Sterling, VA 20165 | 2008-02-06 |
| Find all providers in STERLING | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.