Healthcare Provider Details

I. General information

NPI: 1588892897
Provider Name (Legal Business Name): NAYEEM ESMAIL D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2009
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 S CARLIN SPRINGS RD SUITE 308
ARLINGTON VA
22204-1064
US

IV. Provider business mailing address

611 S CARLIN SPRINGS RD SUITE 308
ARLINGTON VA
22204-1064
US

V. Phone/Fax

Practice location:
  • Phone: 703-998-3971
  • Fax:
Mailing address:
  • Phone: 703-998-3971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number0401412539
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: