Provider Demographics
NPI:1134925027
Name:BASRI, ABEER
Entity type:Individual
Prefix:
First Name:ABEER
Middle Name:
Last Name:BASRI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 ECHOLS ST SE
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22180-4830
Mailing Address - Country:US
Mailing Address - Phone:857-263-1503
Mailing Address - Fax:
Practice Address - Street 1:613 ECHOLS ST SE
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22180-4830
Practice Address - Country:US
Practice Address - Phone:757-739-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014193251223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics