Provider Demographics
NPI:1750177796
Name:AL KALLA, SUMAYA MARWAN (DMD)
Entity type:Individual
Prefix:
First Name:SUMAYA
Middle Name:MARWAN
Last Name:AL KALLA
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:SUMAYA
Other - Middle Name:
Other - Last Name:ALKALLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:6319 CASTLE PL STE 3F
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1907
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6319 CASTLE PL STE 3F
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-1907
Practice Address - Country:US
Practice Address - Phone:972-489-2550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401419382122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist