Provider Demographics
NPI:1922484799
Name:GHALY-HABIB, DINA (BDS , MPH)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:GHALY-HABIB
Suffix:
Gender:F
Credentials:BDS , MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1004 GALIUM CT
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-1106
Mailing Address - Country:US
Mailing Address - Phone:781-879-9224
Mailing Address - Fax:
Practice Address - Street 1:3801 FAIRFAX DR STE 42
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1762
Practice Address - Country:US
Practice Address - Phone:703-988-9455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-04
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA04014178981223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program