MEDICARE: VIRGINIA PERIODONTICS AND IMPLANTS PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1265253900
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIRGINIA PERIODONTICS AND IMPLANTS PLLC

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	:	PERIODONTIST
Name	:	DR. WALEED ALKAKHAN
Credential	:	DDS, MSD, MA
Telephone Number	:	703-489-3226

Provider Enumeration Date	:	10/23/2024
Last Update Date	:	10/23/2024

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