Provider Demographics
NPI:1215143110
Name:SATTAR, HAMID JOHN (DDS)
Entity type:Individual
Prefix:
First Name:HAMID
Middle Name:JOHN
Last Name:SATTAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:H
Other - Last Name:SATTAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:20 PIDGEON HILL DR
Mailing Address - Street 2:SUITE #105
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6154
Mailing Address - Country:US
Mailing Address - Phone:703-450-9723
Mailing Address - Fax:703-450-7782
Practice Address - Street 1:20 PIDGEON HILL DR
Practice Address - Street 2:SUITE #105
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6154
Practice Address - Country:US
Practice Address - Phone:703-450-9723
Practice Address - Fax:703-450-7782
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007537122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist