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General NPI Number Information
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NPI Number | 1093381212
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Entity Type | Individual
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Provider Name | FARAH KHAN
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Gender | Female
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Dates
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Enumeration Date | 05/28/2021
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Last Update Date | 10/24/2023
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Provider Practice Location Address
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Address Line | 72020 JEFFERSON DAVIS HWY #101
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City | DUMFRIES
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State | VA
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Zip | 22026
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Country | US
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Telephone | 703-844-2717
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Fax |
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Provider Business Mailing Address
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Address Line | 16243 EAGLE FLIGHT CIR
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City | WOODBRIDGE
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State | VA
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Zip | 22191-6079
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Country | US
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Telephone | 703-454-2611
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 390200000
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License Number State | DC
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