Kopal Agarwal, DMD
Individual provider Active NPI Dentist · Sterling, VA
NPI 1114569837 · NPPES record last updated Oct 14, 2019
Key facts
- NPI
- 1114569837
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401416712 (VA)
- Practice address
- 21525 Ridgetop Cir Ste 220
Sterling, VA 20166-6577 - Phone
- (703) 450-5302
- NPI assigned
- Oct 14, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401416712 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Ricardo Gaitan | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401416712 | VA | Yes |
Addresses
Primary practice location
21525 Ridgetop Cir Ste 220
Sterling, VA 20166-6577
Mailing address
21525 Ridgetop Cir Ste 220
Sterling, VA 20166-6577
Phone (703) 450-5302
Other names
- Dr. Kopal Mittal
Other providers in Sterling, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.