Provider Demographics
NPI:1841367273
Name:JARWA, SAMER G (DDS)
Entity type:Individual
Prefix:
First Name:SAMER
Middle Name:G
Last Name:JARWA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 BRADDOCK RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032
Mailing Address - Country:US
Mailing Address - Phone:703-323-4024
Mailing Address - Fax:703-323-2048
Practice Address - Street 1:9901 BRADDOCK RD
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032
Practice Address - Country:US
Practice Address - Phone:703-323-4024
Practice Address - Fax:703-323-2048
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA510811223G0001X
VA04014120811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice