Provider Demographics
NPI:1497530034
Name:AL-EID, CRYSTAL LYNNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNNE
Last Name:AL-EID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4403 TWIN KNOLLS CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-1552
Mailing Address - Country:US
Mailing Address - Phone:571-484-4388
Mailing Address - Fax:
Practice Address - Street 1:120 BEULAH RD NE STE 120
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4745
Practice Address - Country:US
Practice Address - Phone:703-938-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418618122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist