Provider Demographics
NPI:1538890132
Name:LITTLE DIAMONDS LLC
Entity type:Organization
Organization Name:LITTLE DIAMONDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DINA
Authorized Official - Middle Name:GRACE
Authorized Official - Last Name:GHALY-HABIB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-879-9224
Mailing Address - Street 1:3801 FAIRFAX DR STE 42
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-1762
Mailing Address - Country:US
Mailing Address - Phone:703-988-7178
Mailing Address - Fax:703-988-7450
Practice Address - Street 1:3801 FAIRFAX DR STE 42
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-1762
Practice Address - Country:US
Practice Address - Phone:703-988-7178
Practice Address - Fax:703-988-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty