Healthcare Provider Details

I. General information

NPI: 1386032597
Provider Name (Legal Business Name): AHMED MATRI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2014
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2944 HUNTER MILL RD STE 202
OAKTON VA
22124-1761
US

IV. Provider business mailing address

2944 HUNTER MILL RD STE 202
OAKTON VA
22124-1761
US

V. Phone/Fax

Practice location:
  • Phone: 703-272-4389
  • Fax: 703-938-2052
Mailing address:
  • Phone: 703-272-4389
  • Fax: 703-938-2052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401414643
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: