Mira Dental Care Pllc | |
1800 N Kent St Suite 100 Arlington VA 22209 | |
(703) 807-0808 | |
(703) 807-8652 |
Full Name | Mira Dental Care Pllc |
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Speciality | Dentist |
Location | 1800 N Kent St, Arlington, Virginia |
Authorized Official Name and Position | Tarek Mohammad Mogharbel (OWNER) |
Authorized Official Contact | 7038070808 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Mira Dental Care Pllc 1800 N Kent St Suite 100 Arlington VA 22209 Ph: (703) 807-0808 | Mira Dental Care Pllc 1800 N Kent St Suite 100 Arlington VA 22209 Ph: (703) 807-0808 |
NPI Number | 1750479697 |
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Provider Enumeration Date | 10/10/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 9133523251 |
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Medicare Enrollment ID | O20210811000578 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750479697 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 0401411296 (Virginia) | Primary |
Provider Name | Tarek M Mogharbel |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1689744104 PECOS PAC ID: 2769809540 Enrollment ID: I20200826000053 |
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