Provider Demographics
NPI:1205984705
Name:AL-KARAGHOLI, MUSTAFA (DDS)
Entity type:Individual
Prefix:DR
First Name:MUSTAFA
Middle Name:
Last Name:AL-KARAGHOLI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8190 STRAWBERRY LN STE 10
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1030
Mailing Address - Country:US
Mailing Address - Phone:703-204-0050
Mailing Address - Fax:703-204-0599
Practice Address - Street 1:8190 STRAWBERRY LN STE 10
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1030
Practice Address - Country:US
Practice Address - Phone:703-204-0050
Practice Address - Fax:703-204-0599
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA4014101751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice