Provider Demographics
NPI:1649687112
Name:GHUMRAWI, RANYA (DMD)
Entity type:Individual
Prefix:DR
First Name:RANYA
Middle Name:
Last Name:GHUMRAWI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 N MOORE ST
Mailing Address - Street 2:501
Mailing Address - City:ROSSLYN
Mailing Address - State:VA
Mailing Address - Zip Code:22209-1728
Mailing Address - Country:US
Mailing Address - Phone:703-807-0808
Mailing Address - Fax:
Practice Address - Street 1:1901 N MOORE ST
Practice Address - Street 2:501
Practice Address - City:ROSSLYN
Practice Address - State:VA
Practice Address - Zip Code:22209-1728
Practice Address - Country:US
Practice Address - Phone:703-807-0808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-16
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414528122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist