Provider Demographics
NPI:1679027601
Name:KAMAL, AHMED (DDS)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:KAMAL
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 1:6100 FRANCONIA RD STE A
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310-2573
Mailing Address - Country:US
Mailing Address - Phone:202-557-9535
Mailing Address - Fax:
Practice Address - Street 1:7787 LEESBURG PIKE
Practice Address - Street 2:STE 200
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2412
Practice Address - Country:US
Practice Address - Phone:202-557-9535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415361122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist