MEDICARE: DR. FARZANEH ROSTAMI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DEN1001418	DC
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	0401413397	VA

General Provider Information

NPI Number	:	1295055762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FARZANEH ROSTAMI DDS

Provider Business Mailing Address
First Line	:	611 S CARLIN SPRINGS RD STE 308
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22204-1086
Country	:	US
Telephone Number	:	703-379-2700
Fax Number	:	703-995-0813

Provider Business Practice Location Address
First Line	:	1145 19TH ST NW STE 777
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20036-3744
Country	:	US
Telephone Number	:	22-296-6600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2010
Last Update Date	:	05/27/2026

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