Provider Demographics
NPI:1851585434
Name:HAMRAH, DARIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DARIA
Middle Name:
Last Name:HAMRAH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2414 N VERMONT ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-4005
Mailing Address - Country:US
Mailing Address - Phone:703-269-8467
Mailing Address - Fax:
Practice Address - Street 1:8201 GREENSBORO DR
Practice Address - Street 2:SUITE # 601
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3810
Practice Address - Country:US
Practice Address - Phone:703-269-8467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX232761223S0112X
VA04014121101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery