Provider Demographics
NPI:1710173950
Name:FEISAL OSMAN DDS
Entity Type:Organization
Organization Name:FEISAL OSMAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FEISAL
Authorized Official - Middle Name:
Authorized Official - Last Name:OSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:804-364-1696
Mailing Address - Street 1:3033 LAUDERDALE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23233
Mailing Address - Country:US
Mailing Address - Phone:804-364-1696
Mailing Address - Fax:804-360-0756
Practice Address - Street 1:3033 LAUDERDALE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-364-1696
Practice Address - Fax:804-360-0756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007712122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA228966OtherANTHEM
VA908748OtherUNITED CONCORDIA
VA7801688Medicaid