David S Hijab, D.D.S, P.A.
Individual provider Active NPI General Practice Dentistry · Lavale, MD
NPI 1205919768 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1205919768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 12919 (MD)
- Practice address
- 13106 Winchester Rd SW
Lavale, MD 21502-6035 - Phone
- (301) 729-1000
- Fax
- (301) 729-0500
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12919 | MD | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12919 | MD | Yes |
Addresses
Primary practice location
13106 Winchester Rd SW
Lavale, MD 21502-6035
Mailing address
13106 Winchester Rd SW
Lavale, MD 21502-6035
Phone (301) 729-1000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1303248 | Other | MD | UNITED CONCORDIA PROVIDER |
| ZZPKDA | Other | MD | CFMI DENTAL NUMBER |
| 204046042001 | Other | MD | CAREFIRST BCBS REGIONAL # |
Other providers in Lavale, MD
- Caroline Lee Hann
- Mohammed Wassaif Haque
- Michael Carter Harpold
- Sarah Faye Hart
- Mary Elizabeth Henderson
- Danielle Hook
- Dora Carew John-Betts
- Samantha Judy
- Brooke Ellen Keefner
- Lori Keister
All providers in Lavale, MD · General Practice Dentistry in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.