Provider Demographics
NPI:1881348951
Name:AL-KARAGHOLI DENTISTRY OF MERRIFIELD PC
Entity type:Organization
Organization Name:AL-KARAGHOLI DENTISTRY OF MERRIFIELD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-KARAGHOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-204-0050
Mailing Address - Street 1:8190 STRAWBERRY LN STE 10
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1030
Mailing Address - Country:US
Mailing Address - Phone:703-204-0050
Mailing Address - Fax:
Practice Address - Street 1:8190 STRAWBERRY LN STE 10
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1030
Practice Address - Country:US
Practice Address - Phone:703-204-0050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty