Provider Demographics
NPI:1144211046
Name:ANGAMUTHU, VIJAYALAKSHMI NATARAJAN (DDS)
Entity type:Individual
Prefix:
First Name:VIJAYALAKSHMI
Middle Name:NATARAJAN
Last Name:ANGAMUTHU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11007 BRADBURY MANOR CT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-4571
Mailing Address - Country:US
Mailing Address - Phone:301-593-4107
Mailing Address - Fax:410-281-1861
Practice Address - Street 1:1726 N ROLLING RD
Practice Address - Street 2:
Practice Address - City:WINDSOR MILL
Practice Address - State:MD
Practice Address - Zip Code:21244-2408
Practice Address - Country:US
Practice Address - Phone:410-281-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD122461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice