Healthcare Provider Details

I. General information

NPI: 1477355865
Provider Name (Legal Business Name): PERIOWORKS ALEXANDRIA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 S PICKETT ST STE 30
ALEXANDRIA VA
22304-7206
US

IV. Provider business mailing address

50 S PICKETT ST STE 30
ALEXANDRIA VA
22304-7206
US

V. Phone/Fax

Practice location:
  • Phone: 216-334-5813
  • Fax:
Mailing address:
  • Phone: 216-334-5813
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: HAZEM SAQQAL
Title or Position: PERIODONTIST/OWNER
Credential: DDS, MSD
Phone: 216-334-5813