Healthcare Provider Details

I. General information

NPI: 1013222538
Provider Name (Legal Business Name): AHMED ASHYK SYKANDER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14642 LEE HWY
GAINESVILLE VA
20155-2119
US

IV. Provider business mailing address

14642 LEE HWY
GAINESVILLE VA
20155-2119
US

V. Phone/Fax

Practice location:
  • Phone: 703-754-7110
  • Fax: 703-754-7705
Mailing address:
  • Phone: 703-754-7110
  • Fax: 703-754-7705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60136990
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401415098
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: