Provider Demographics
NPI:1760692511
Name:KRISHNAMOORTHY, SAVITHA (DMD)
Entity type:Individual
Prefix:DR
First Name:SAVITHA
Middle Name:
Last Name:KRISHNAMOORTHY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24805 PINEBROOK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-4128
Mailing Address - Country:US
Mailing Address - Phone:703-327-3334
Mailing Address - Fax:703-327-3755
Practice Address - Street 1:24805 PINEBROOK RD STE 200
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20152-4128
Practice Address - Country:US
Practice Address - Phone:703-327-3334
Practice Address - Fax:703-327-3755
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014109821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice