| Merdad Dentistry Pllc | |
|
7522 Old Linton Hall Rd Gainesville VA 20155-1731 | |
| (857) 654-0359 | |
| Not Available |
| Full Name | Merdad Dentistry Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 7522 Old Linton Hall Rd, Gainesville, Virginia |
| Authorized Official Name and Position | Hisham Essam A Merdad (OWNER CEO) |
| Authorized Official Contact | 8576540359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Merdad Dentistry Pllc 750 Port St Apt 1626 Alexandria VA 22314-6472 Ph: (857) 654-0359 | Merdad Dentistry Pllc 7522 Old Linton Hall Rd Gainesville VA 20155-1731 Ph: (857) 654-0359 |
| NPI Number | 1336642388 |
|---|---|
| Provider Enumeration Date | 03/15/2018 |
| Last Update Date | 03/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336642388 | NPI | - | NPPES |
| 1144656356 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 0401414352 (Virginia) | Primary |
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