Hala Elham Imam, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0401416073 Issued in VA

Practice address

1976 Crescent Park Dr
Reston, VA 20190-3288

Phone

(703) 867-7920

NPI assigned

Jun 18, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1245724806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1976 CRESCENT PARK DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903288",
            "telephone_number": "703-867-7920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1976 CRESCENT PARK DR",
            "city": "RESTON",
            "state": "VA",
            "postal_code": "201903288",
            "telephone_number": "703-867-7920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMAM",
        "first_name": "HALA",
        "middle_name": "ELHAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-18",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416073",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Arthur Hyman, PH.D.
• Christine Ibarguen, NP
• Itoro Ibia, M.D.
• Ida Sue Baron, PH.D., P.C.
• Amazing-Grace Ighedo
• Mfrie-Emem Ifiok Imoh, LPC
• Renee Indelicato, OT
• Indomitable Spirit, LLC (CEIO Nutrition)
• Donald S Infeld, MD
• Ann B Iniguez, LPC-R

• General Practice Dentistry in Reston, VA
• Providers in Reston, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.