Provider Demographics
NPI:1285053637
Name:ABDEL-WAHAB, MONA (DDS)
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:ABDEL-WAHAB
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8219 WESTWOOD MEWS CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-6016
Mailing Address - Country:US
Mailing Address - Phone:202-294-6725
Mailing Address - Fax:
Practice Address - Street 1:8219 WESTWOOD MEWS CT
Practice Address - Street 2:
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-6016
Practice Address - Country:US
Practice Address - Phone:202-294-6725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014139291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics