Provider Demographics
NPI:1376061168
Name:HAMDOON, SAMA (DDS)
Entity Type:Individual
Prefix:
First Name:SAMA
Middle Name:
Last Name:HAMDOON
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 1:14701 RIVER WALK WAY APT 396
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-5980
Mailing Address - Country:US
Mailing Address - Phone:703-865-9000
Mailing Address - Fax:
Practice Address - Street 1:10454 HILLTOP PLAZA WAY
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-2100
Practice Address - Country:US
Practice Address - Phone:714-428-1379
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-31
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415776122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist