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General NPI Number Information
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NPI Number | 1518841519
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Entity Type | Organization
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Legal Business Name | DREAM MOBILE SEDATION PLLC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 01/25/2026
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Provider Practice Location Address
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Address Line | 6508 FAWN HOLLOW PL
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City | CENTREVILLE
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State | VA
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Zip | 20120-1050
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Country | US
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Telephone | 703-830-3938
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Fax | 703-830-0186
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Provider Business Mailing Address
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Address Line | 6508 FAWN HOLLOW PL
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City | CENTREVILLE
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State | VA
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Zip | 20120-1050
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Country | US
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Telephone | 703-830-3938
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Fax | 703-830-0186
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Authorized Official
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Title or Position | DENTIST ANESTHESIOLOGIST
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Name | WISSAM FAWZI ALI
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Credential | DMD
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Telephone | 571-221-5737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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