Provider Demographics
NPI:1376182196
Name:ALEXANDRIA DENTISTRY PLLC
Entity Type:Organization
Organization Name:ALEXANDRIA DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAREQ
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAMEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-751-3880
Mailing Address - Street 1:6000 STEVENSON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22304-3526
Mailing Address - Country:US
Mailing Address - Phone:703-751-3880
Mailing Address - Fax:703-751-3950
Practice Address - Street 1:6000 STEVENSON AVE STE 103
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-3526
Practice Address - Country:US
Practice Address - Phone:703-751-3880
Practice Address - Fax:703-751-3950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-26
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental