MEDICARE: DR. WASIM QURESHI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401413931	VA

General Provider Information

NPI Number	:	1326393117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WASIM QURESHI DDS

Provider Business Mailing Address
First Line	:	21001 SYCOLIN RD STE 100
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-4074
Country	:	US
Telephone Number	:	571-291-9699
Fax Number	:

Provider Business Practice Location Address
First Line	:	21001 SYCOLIN RD STE 100
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-4074
Country	:	US
Telephone Number	:	571-291-9699
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	10/24/2023

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