Provider Demographics
NPI:1548016710
Name:SAXENA, SONAM RAGINI
Entity type:Individual
Prefix:
First Name:SONAM
Middle Name:RAGINI
Last Name:SAXENA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 ROWLAND LN
Mailing Address - Street 2:
Mailing Address - City:LINE LEXINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18932-1302
Mailing Address - Country:US
Mailing Address - Phone:215-450-8093
Mailing Address - Fax:
Practice Address - Street 1:6537 ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-3001
Practice Address - Country:US
Practice Address - Phone:571-620-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-27
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN20003931223G0001X
MD182381223G0001X
VA04014189571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice