# DIAMOND DENTAL CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144586298
- **Authorized official:** DR. AMAL ALI DDS (GENERAL DENTIST)
- **Authorized official phone:** (703) 773-1212

## Contact information

- **Practice address:** 13948 LEE JACKSON MEMORIAL HWY, CHANTILLY, VA 20151-3202
- **Practice address phone:** (703) 773-1212
- **Practice address fax:** (703) 773-1214
- **Mailing address:** 13948 LEE JACKSON MEMORIAL HIGHWAY, CHANTILLY, VA 20151
- **Mailing address phone:** (703) 773-1212
- **Mailing address fax:** (703) 773-1214

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401008860 | VA | Yes |

## Other

- **Enumeration date:** 04/03/2012
- **Last updated:** 04/03/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 010378214 | — | VA |