Barry R. Maharaj, DDS & Anh H. Pham, DDS, PC

Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Lansdowne, VA

NPI 1093889008 · NPPES record last updated Aug 21, 2013

Key facts

NPI
1093889008
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
0401006304 (VA)
Legal business name
BARRY R. MAHARAJ, DDS & ANH H. PHAM, DDS, PC
Practice address
19441 Golf Vista Plaza
Suite 130
Lansdowne, VA 20176
Phone
(703) 723-7858
Fax
(703) 723-7882
NPI assigned
Nov 20, 2006
Organization subpart
No

Authorized official

Name
Ms. Kaiti R Grim, CMOM
Title
Administrative Dirct
Phone
(703) 723-7858

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

19441 Golf Vista Plz
Ste 130
Lansdowne, VA 20176
Phone (703) 723-7858

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223S0112X 0401006304 VA Yes
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223S0112X 0401410305 VA
Oral and Maxillofacial Surgery (Dentist)
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223S0112X 0401413171 VA

Addresses

Primary practice location

19441 Golf Vista Plaza
Suite 130
Lansdowne, VA 20176

Mailing address

19441 Golf Vista Plaza
Suite 130
Lansdowne, VA 20176
Phone (703) 723-7858

Other identifiers

IdentifierTypeStateIssuer
292375OtherMDMAMSI OP CHOICE ALLIANCE
384081OtherVABCBS
008000531MedicaidVA
455676OtherMDMAMSI OP CHOICE ALLIANCE
008000492MedicaidVA
384338OtherVABCBS

Other names

  • Lansdowne Oral Surgery Doing business as

Other providers in Lansdowne, VA

All providers in Lansdowne, VA · Oral and Maxillofacial Surgery (Dentist) in Virginia

Sources for this page

Verify at the official NPI Registry.