Provider Demographics
NPI:1376271049
Name:HAMID, LAYTH (DMD)
Entity Type:Individual
Prefix:
First Name:LAYTH
Middle Name:
Last Name:HAMID
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22053 CHELSY PAIGE SQ
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20148-7105
Mailing Address - Country:US
Mailing Address - Phone:346-304-1737
Mailing Address - Fax:
Practice Address - Street 1:9661 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3739
Practice Address - Country:US
Practice Address - Phone:571-364-7943
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418112122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist