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General NPI Number Information
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NPI Number | 1780358606
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Entity Type | Individual
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Provider Name | RABEE ITMAIZA DDS
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Gender | Male
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Dates
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Enumeration Date | 08/04/2021
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Last Update Date | 08/04/2021
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Provider Practice Location Address
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Address Line | 3701 S GEORGE MASON DR UNIT C7N
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City | FALLS CHURCH
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State | VA
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Zip | 22041-4722
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Country | US
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Telephone | 703-998-8826
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Fax | 703-998-8828
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Provider Business Mailing Address
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Address Line | 1040 DULANEY MILL DR
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City | FREDERICK
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State | MD
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Zip | 21702-6227
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Country | US
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Telephone | 240-409-5010
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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 | 0401417606
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License Number State | VA
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