Provider Demographics
NPI:1902071103
Name:AHMED, GAAFAR MOHAMMED GAAFAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:GAAFAR
Middle Name:MOHAMMED GAAFAR
Last Name:AHMED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12351 DILLINGHAM SQ
Mailing Address - Street 2:
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-5251
Mailing Address - Country:US
Mailing Address - Phone:703-580-8288
Mailing Address - Fax:703-590-2382
Practice Address - Street 1:12351 DILLINGHAM SQ
Practice Address - Street 2:
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-5251
Practice Address - Country:US
Practice Address - Phone:703-580-8288
Practice Address - Fax:703-590-2382
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411971122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist