Provider Demographics
NPI:1962072025
Name:ATRASH, SAMEER (DMD)
Entity type:Individual
Prefix:
First Name:SAMEER
Middle Name:
Last Name:ATRASH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 RIPPLING POND DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-5078
Mailing Address - Country:US
Mailing Address - Phone:703-973-3956
Mailing Address - Fax:
Practice Address - Street 1:300 TAZEWELL ST
Practice Address - Street 2:
Practice Address - City:PEARISBURG
Practice Address - State:VA
Practice Address - Zip Code:24134-1730
Practice Address - Country:US
Practice Address - Phone:540-921-3323
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-30
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401417542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist