Provider Demographics
NPI:1063390425
Name:ASHBURN DENTISTRY BY DESIGN
Entity type:Organization
Organization Name:ASHBURN DENTISTRY BY DESIGN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHALIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-841-0300
Mailing Address - Street 1:20905 PROFESSIONAL PLZ STE 210
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-3409
Mailing Address - Country:US
Mailing Address - Phone:703-723-9909
Mailing Address - Fax:
Practice Address - Street 1:20905 PROFESSIONAL PLZ STE 210
Practice Address - Street 2:
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-3409
Practice Address - Country:US
Practice Address - Phone:703-723-9909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental