Provider Demographics
NPI:1720123292
Name:KHARMOUCHE, JEAN-CLAUDE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JEAN-CLAUDE
Middle Name:
Last Name:KHARMOUCHE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21165 WHITFIELD PL STE 107
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-7276
Mailing Address - Country:US
Mailing Address - Phone:703-444-4377
Mailing Address - Fax:703-444-7383
Practice Address - Street 1:21165 WHITFIELD PL STE 107
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-7276
Practice Address - Country:US
Practice Address - Phone:703-444-4377
Practice Address - Fax:703-444-7383
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010088091223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics