Healthcare Provider Details

I. General information

NPI: 1386538130
Provider Name (Legal Business Name): ATIYEH EMAM DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44135 WOODRIDGE PKWY STE 280
LANSDOWNE VA
20176-1244
US

IV. Provider business mailing address

44135 WOODRIDGE PKWY STE 280
LANSDOWNE VA
20176-1244
US

V. Phone/Fax

Practice location:
  • Phone: 703-858-9200
  • Fax: 703-858-9542
Mailing address:
  • Phone: 703-858-9200
  • Fax: 703-858-9542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ATIYEH EMAM
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 703-858-9200