Provider Demographics
NPI:1376826495
Name:MUNASAR, FEKRI MAHMOOD (DDS)
Entity type:Individual
Prefix:DR
First Name:FEKRI
Middle Name:MAHMOOD
Last Name:MUNASAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:FEKRI
Other - Middle Name:TAHER
Other - Last Name:ABDULLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:650 PENNSYLVANIA AVE SE STE 460
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4348
Mailing Address - Country:US
Mailing Address - Phone:202-547-7772
Mailing Address - Fax:202-547-7796
Practice Address - Street 1:650 PENNSYLVANIA AVE SE STE 460
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-4348
Practice Address - Country:US
Practice Address - Phone:202-547-7772
Practice Address - Fax:202-547-7796
Is Sole Proprietor?:No
Enumeration Date:2011-09-25
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10010891223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1862533Medicaid