Provider Demographics
NPI:1346517000
Name:AKMAL, OMER FAROOQ (DDS)
Entity Type:Individual
Prefix:
First Name:OMER
Middle Name:FAROOQ
Last Name:AKMAL
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 1:4141 N HENDERSON RD APT 412
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2459
Mailing Address - Country:US
Mailing Address - Phone:202-277-6444
Mailing Address - Fax:
Practice Address - Street 1:915 N QUINCY ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1907
Practice Address - Country:US
Practice Address - Phone:703-276-1010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0376791223G0001X
VA04014136571223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice