Provider Demographics
NPI:1508171711
Name:AWADA, ABDALLAH (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:ABDALLAH
Middle Name:
Last Name:AWADA
Suffix:
Gender:M
Credentials:DDS MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8219 LEESBURG PIKE STE 100
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2625
Mailing Address - Country:US
Mailing Address - Phone:703-448-0190
Mailing Address - Fax:
Practice Address - Street 1:8219 LEESBURG PIKE STE 100
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2625
Practice Address - Country:US
Practice Address - Phone:703-448-0190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014143221223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics