Provider Demographics
NPI:1386010320
Name:KHALF-ALLAH, DINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:KHALF-ALLAH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 N NEVADA AVE
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903-1708
Mailing Address - Country:US
Mailing Address - Phone:719-323-2362
Mailing Address - Fax:719-631-2506
Practice Address - Street 1:1060 BRENTWOOD RD NE STE B-1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1052
Practice Address - Country:US
Practice Address - Phone:202-269-4746
Practice Address - Fax:202-269-6994
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415002122300000X
DCDEN1001561122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist