Provider Demographics
NPI:1609224567
Name:YOSRELDIN KOHEIL DDS PLC
Entity Type:Organization
Organization Name:YOSRELDIN KOHEIL DDS PLC
Other - Org Name:FREDERICKSBURG DENTAL ARTISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOSRELDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHEIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-908-3888
Mailing Address - Street 1:10040 JEFFERSON DAVIS HWY
Mailing Address - Street 2:STE 112
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9431
Mailing Address - Country:US
Mailing Address - Phone:540-908-3888
Mailing Address - Fax:540-908-3888
Practice Address - Street 1:10040 JEFFERSON DAVIS HWY
Practice Address - Street 2:STE 112
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-9431
Practice Address - Country:US
Practice Address - Phone:540-908-3888
Practice Address - Fax:540-908-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-01
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014131541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty