Healthcare Provider Details

I. General information

NPI: 1992624209
Provider Name (Legal Business Name): 703 DENTAL DUMFRIES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17119 WAYSIDE DR
DUMFRIES VA
22026-2766
US

IV. Provider business mailing address

17119 WAYSIDE DR
DUMFRIES VA
22026-2766
US

V. Phone/Fax

Practice location:
  • Phone: 703-348-9395
  • Fax:
Mailing address:
  • Phone: 703-348-9395
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: BILAL ALI
Title or Position: DENTIST
Credential: DDS
Phone: 703-348-9395