Healthcare Provider Details

I. General information

NPI: 1952291445
Provider Name (Legal Business Name): RANYA ABBAS SHARIF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 SAINT PATRICKS DR
WALDORF MD
20603-4574
US

IV. Provider business mailing address

2455 MANDEVILLE LN APT 1119
ALEXANDRIA VA
22314-6150
US

V. Phone/Fax

Practice location:
  • Phone: 301-870-4553
  • Fax:
Mailing address:
  • Phone: 832-983-2320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18905
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: