Healthcare Provider Details

I. General information

NPI: 1548157225
Provider Name (Legal Business Name): WRA PERIO, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2025
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 BEVERLY RD STE 210
MC LEAN VA
22101-3654
US

IV. Provider business mailing address

1355 BEVERLY RD STE 210
MC LEAN VA
22101-3654
US

V. Phone/Fax

Practice location:
  • Phone: 703-288-3570
  • Fax:
Mailing address:
  • Phone: 703-288-3570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WALEED ALKAKHAN
Title or Position: MANAGING MEMBER
Credential: DDS
Phone: 703-489-3226