MEDICARE: DR. WALEED RABAH ALKAKHAN DDS, MSD, MA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0300X	Periodontics	0401416769	VA

General Provider Information

NPI Number	:	1194286898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WALEED RABAH ALKAKHAN DDS, MSD, MA

Provider Business Mailing Address
First Line	:	2727 S QUINCY ST APT 1224
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-2362
Country	:	US
Telephone Number	:	703-489-3226
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 S QUINCY ST APT 1224
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22206-2362
Country	:	US
Telephone Number	:	703-489-3226
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	02/27/2025

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