Provider Demographics
NPI:1447506019
Name:ISKANDER, ERENE I (DDS)
Entity type:Individual
Prefix:
First Name:ERENE
Middle Name:I
Last Name:ISKANDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4565 WHITTEMORE PL
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6272
Mailing Address - Country:US
Mailing Address - Phone:703-955-2480
Mailing Address - Fax:
Practice Address - Street 1:4565 WHITTEMORE PL
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6272
Practice Address - Country:US
Practice Address - Phone:703-955-2480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413683122300000X
DCDEN1001141122300000X
MD15158122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist