Divya Kanodia

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

0401417622 Issued in VA

Practice address

13880 Braddock Rd Ste 307
Centreville, VA 20121-2462

Phone

(703) 815-3636

NPI assigned

Aug 11, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628640000000",
    "number": "1619642733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "733 15TH ST NW APT 216",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200052136",
            "telephone_number": "617-230-2904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13880 BRADDOCK RD STE 307",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212462",
            "telephone_number": "703-815-3636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANODIA",
        "first_name": "DIVYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2021-08-11",
        "certification_date": "2021-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "VA",
            "license": "0401417622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Kaleli-Lee, M.A.
• Kristina Kallini, LCSW
• Seok Kang, PH.D.
• Seong Kang, OPTICIAN
• Young-Hee Kang
• Mohammad Hafiz Karimi
• Shiraz Kashani, MS, OTR/L
• Frinet Margarita Kasper, D.D.S.
• Kathleen B. Moore, OD
• Sarah Sonya Kazarian, DPT, PT

• Endodontics in Centreville, VA
• Providers in Centreville, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.