Provider Demographics
NPI:1760678569
Name:SAID M. KHALEFA DDS, PC
Entity type:Organization
Organization Name:SAID M. KHALEFA DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAID
Authorized Official - Middle Name:M
Authorized Official - Last Name:KHALEFA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-451-4211
Mailing Address - Street 1:6115 BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2626
Mailing Address - Country:US
Mailing Address - Phone:703-451-4211
Mailing Address - Fax:703-913-8555
Practice Address - Street 1:4600B PINECREST OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22312-1460
Practice Address - Country:US
Practice Address - Phone:703-914-0020
Practice Address - Fax:703-914-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-15
Last Update Date:2007-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA7592122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty