Provider Demographics
NPI:1699816330
Name:KHALEFA, SAID MUHAMMAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAID
Middle Name:MUHAMMAD
Last Name:KHALEFA
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 1:6115 BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2626
Mailing Address - Country:US
Mailing Address - Phone:703-451-4211
Mailing Address - Fax:703-913-8555
Practice Address - Street 1:6115 BACKLICK RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2626
Practice Address - Country:US
Practice Address - Phone:703-451-4211
Practice Address - Fax:703-913-8555
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA75921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice