Provider Demographics
NPI:1609024199
Name:EMAD, NEAL R (DDS)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:R
Last Name:EMAD
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 1:307 MAPLE AVE W STE F
Mailing Address - Street 2:SUITE#100
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4307
Mailing Address - Country:US
Mailing Address - Phone:703-938-7615
Mailing Address - Fax:703-242-9417
Practice Address - Street 1:307 MAPLE AVE W STE F
Practice Address - Street 2:SUITE#100
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4307
Practice Address - Country:US
Practice Address - Phone:703-938-7615
Practice Address - Fax:703-242-9417
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2011-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA71851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice