| Doctor Name: | DR. MARIAM ABDELRAZIG KHATEEB |
| NPI Number: | 1275722027 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DMD |
| License Number: | 0401400753 |
| Business Practice Address: | 238 Potomac Ave Quantico, VA - 221343459 |
| Business Phone Number: | 7036401000 |
| Business Fax Number: | 7036302526 |
| Mailing Address: | 5200 Lyngate Ct, BURKE |
| State: | VA |
| Postal Code: | 220151631 |
| Phone Number: | 7039781903 |
| Fax Number: | |
| NPI Enumeration Date: | 10/17/2007 |
| NPI Last Update Date: | 10/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1223P0221X |
| License Number: | 0401400753 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Dental Providers |
| Taxonomy Classification: | Dentist |
| Taxonomy Specialization: | Pediatric Dentistry |
| Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |