Provider Demographics
NPI:1477895357
Name:GHORAB, RAMI NABIL (DDS)
Entity Type:Individual
Prefix:
First Name:RAMI
Middle Name:NABIL
Last Name:GHORAB
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 1:10635 SUMMER OAK CT
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2235
Mailing Address - Country:US
Mailing Address - Phone:703-975-8713
Mailing Address - Fax:
Practice Address - Street 1:3650 S GLEBE RD STE 195
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-5606
Practice Address - Country:US
Practice Address - Phone:703-304-3881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA04014143751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program