Provider Demographics
NPI:1073685491
Name:AKEEL, ED ALY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ED
Middle Name:ALY
Last Name:AKEEL
Suffix:
Gender:M
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:P.O. BOX 8065
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906
Mailing Address - Country:US
Mailing Address - Phone:434-975-6181
Mailing Address - Fax:434-220-3157
Practice Address - Street 1:2003 WOODBROOK COURT
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:434-975-6181
Practice Address - Fax:434-220-3157
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4010084601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice