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General NPI Number Information
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NPI Number | 1023217593
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Entity Type | Individual
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Provider Name | MOHAMED H. ATTIA DDS, FAGD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2007
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Last Update Date | 02/17/2015
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Provider Practice Location Address
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Address Line | 6420 GROVEDALE DR SUITE 100A
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2500
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Country | US
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Telephone | 703-719-9305
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Fax | 703-719-9139
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Provider Business Mailing Address
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Address Line | 6420 GROVEDALE DR SUITE 100A
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City | ALEXANDRIA
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State | VA
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Zip | 22310
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Country | US
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Telephone | 703-719-9305
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Fax | 703-719-9139
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401412033
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 150620
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License Number State | NC
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