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Individual

ANAMIKA REEYA KHOSLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
111 HULL ST APT 405, RICHMOND, VA 23224-4205
(713) 823-4216
Mailing address
24911 LAGUNA EDGE DR, KATY, TX 77494-3923
(713) 823-4216

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401418362
VA
1223G0001X
General Practice Dentistry
37429
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019.033312
ILLINOIS LICENSE
IL
01
0401418362
VIRGINIA LICENSE
VA
01
37429
TEXAS LICENSE
TX
Enumeration date
07/09/2021
Last updated
06/29/2023
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