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General NPI Number Information
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NPI Number | 1073736377
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Entity Type | Individual
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Provider Name | KHALID MANSOUR HUSSEIN DDS
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3900 FAIRFAX DRIVE APT 224
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City | ARLINGTON
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State | VA
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Zip | 22203-1662
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Country | US
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Telephone | 571-201-7416
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Fax |
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Provider Business Mailing Address
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Address Line | 3900 FAIRFAX DRIVE APT 224
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City | ARLINGTON
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State | VA
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Zip | 22203-1662
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Country | US
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Telephone | 571-201-7416
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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 | 1000489
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License Number State | DC
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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 | 0401411564
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0513531
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13576
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License Number State | MD
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