Healthcare Provider Details

I. General information

NPI: 1548195860
Provider Name (Legal Business Name): ANAS ABUALALA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10324 IRON BRIDGE RD
CHESTER VA
23831-1425
US

IV. Provider business mailing address

11800 AUTUMNWOOD CT
GLEN ALLEN VA
23059-2546
US

V. Phone/Fax

Practice location:
  • Phone: 804-803-9823
  • Fax:
Mailing address:
  • Phone: 202-878-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401420010
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: