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Organization
PROVIDENCE DENTAL ARTS
Active
Organization
PROVIDENCE DENTAL ARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISSA I ABOU AYYASH (DENTIST)
(301) 222-7896
Entity
Organization
Contact information
Practice address
3028 JAVIER RD STE 101, FAIRFAX, VA 22031-4622
(301) 222-7896
(301) 222-7896
Mailing address
3028 JAVIER RD STE 101, FAIRFAX, VA 22031-4622
(301) 222-7896
(301) 222-7896
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
NULL
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/25/2026
Last updated
05/25/2026
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