Provider Demographics
NPI:1649934639
Name:SAADOON, AHMED ALI
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:ALI
Last Name:SAADOON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21786 WILLESDEN JUNCTION TER
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-9275
Mailing Address - Country:US
Mailing Address - Phone:571-722-0147
Mailing Address - Fax:
Practice Address - Street 1:5645 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2867
Practice Address - Country:US
Practice Address - Phone:703-379-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-26
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417591122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist