Healthcare Provider Details
I. General information
NPI: 1619177854
Provider Name (Legal Business Name): NAHEE WILLIAMS MCDONALD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/24/2007
Last Update Date: 10/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7841 ROLLING ROAD SUITE F
SPRINGFIELD VA
22153
US
IV. Provider business mailing address
7841 ROLLING ROAD SUITE F
SPRINGFIELD VA
22153
US
V. Phone/Fax
- Phone: 703-455-1339
- Fax:
- Phone: 703-455-1339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | 0401411394 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | 13592 |
| License Number State | MD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223P0221X |
| Taxonomy | Pediatric Dentistry |
| License Number | DEN1000702 |
| License Number State | DC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: