Provider Demographics
NPI:1457092397
Name:JUMAA, AHMAD SUBHI (DDS)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:SUBHI
Last Name:JUMAA
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 1:240 MORAGA ST APT 202
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-3673
Mailing Address - Country:US
Mailing Address - Phone:954-940-2815
Mailing Address - Fax:
Practice Address - Street 1:2149 BARRACKS RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-4810
Practice Address - Country:US
Practice Address - Phone:344-240-2824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418613122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist