MEDICARE: KHALID M HUSSEIN DDS PC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1922668524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KHALID M HUSSEIN DDS PC

Provider Business Mailing Address
First Line	:	1712 I ST NW STE 906
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-3702
Country	:	US
Telephone Number	:	202-496-0891
Fax Number	:	202-496-0894

Provider Business Practice Location Address
First Line	:	1712 I ST NW STE 906
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-3702
Country	:	US
Telephone Number	:	202-496-0891
Fax Number	:	202-496-0894

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KHALID M HUSSEIN
Credential	:	DDS
Telephone Number	:	202-496-0891

Provider Enumeration Date	:	06/17/2019
Last Update Date	:	06/17/2019

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