Provider Demographics
NPI:1174742589
Name:KHALIL, JOSEPH A (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:KHALIL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 N HIGHLAND ST
Mailing Address - Street 2:STE. 130B-S
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-2112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1012 N HIGHLAND ST
Practice Address - Street 2:STE. 130B-S
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2112
Practice Address - Country:US
Practice Address - Phone:703-841-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014107151223G0001X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223P0700XDental ProvidersDentistProsthodontics