Bana Al Haydar, DDS,MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

0401417657 Issued in VA

Practice address

609 Jefferson Davis Hwy Ste 101
Fredericksburg, VA 22401-4566

Phone

(540) 373-3066

NPI assigned

Oct 4, 2021

Last updated

Oct 4, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1811669203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 39TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152904",
            "telephone_number": "202-823-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 JEFFERSON DAVIS HWY STE 101",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014566",
            "telephone_number": "540-373-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL HAYDAR",
        "first_name": "BANA",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VA",
            "license": "0401417657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arvin Akhavan, MD
• Melis Akin, MED,LPC-S, NCC
• Alex England Akman, MD
• Shawn Akram, DO
• Vishal Akula
• Mahmood Ali Al Taie, RPH
• Ali Al-Douri, DDS
• Nadeen Al-Ghandour, OD
• Zukaey Al-Lababidi, DDS
• Jessica Jaw Al-Mashat, M.D.

• Periodontics in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Periodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.