Provider Demographics
NPI:1730332636
Name:OMAR, ANISA (DDS)
Entity type:Individual
Prefix:DR
First Name:ANISA
Middle Name:
Last Name:OMAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4434 MACARTHUR BLVD NW
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-2550
Mailing Address - Country:US
Mailing Address - Phone:202-333-3883
Mailing Address - Fax:202-333-3881
Practice Address - Street 1:4434 MACARTHUR BLVD NW
Practice Address - Street 2:SUITE # 201
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20007-2550
Practice Address - Country:US
Practice Address - Phone:202-333-3883
Practice Address - Fax:202-333-3881
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCDEN10007461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics