Provider Demographics
NPI:1013621937
Name:REHAN, ASIA ELAHI
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:ELAHI
Last Name:REHAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17008 GIBSON MILL RD
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22026-2285
Mailing Address - Country:US
Mailing Address - Phone:703-986-8076
Mailing Address - Fax:
Practice Address - Street 1:17181 WAYSIDE DR
Practice Address - Street 2:
Practice Address - City:DUMFRIES
Practice Address - State:VA
Practice Address - Zip Code:22026-2766
Practice Address - Country:US
Practice Address - Phone:571-380-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-06
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402207912124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist