MEDICARE: DR. RANA TUFFAHA D.M.D

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	1223G0001X	General Practice Dentistry	0401413001	VA

General Provider Information

NPI Number	:	1447569454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RANA TUFFAHA D.M.D

Provider Business Mailing Address
First Line	:	1120 BROADHOLME PL
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23455-6882
Country	:	US
Telephone Number	:	813-523-9126
Fax Number	:

Provider Business Practice Location Address
First Line	:	6095 INDIAN RIVER RD
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3818
Country	:	US
Telephone Number	:	757-424-1976
Fax Number	:

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

Provider Enumeration Date	:	09/26/2010
Last Update Date	:	09/26/2010

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