Provider Demographics
NPI:1689268104
Name:KATMEH, KHALED (DDS)
Entity Type:Individual
Prefix:DR
First Name:KHALED
Middle Name:
Last Name:KATMEH
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 1:1230 YOUNGS RD UNIT E
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2657
Mailing Address - Country:US
Mailing Address - Phone:502-724-5075
Mailing Address - Fax:
Practice Address - Street 1:9 HOLLY HILL DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2559
Practice Address - Country:US
Practice Address - Phone:804-733-9490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014173431223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty