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General NPI Number Information
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NPI Number | 1013745686
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Entity Type | Individual
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Provider Name | RITA EL KHOURY DMD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 12 PGA DR SUITE 201
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City | STAFFORD
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State | VA
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Zip | 22554
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Country | US
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Telephone | 540-720-2627
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Fax |
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Provider Business Mailing Address
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Address Line | 8570 TYROLEAN WAY
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City | SPRINGFIELD
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State | VA
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Zip | 22153-2240
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Country | US
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Telephone | 301-541-6289
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401418902
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License Number State | VA
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