MEDICARE: ALIREZA PALIZI, D.D.S., P.C.

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	1223G0001X	General Practice Dentistry	0401411519	VA

General Provider Information

NPI Number	:	1316060213
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIREZA PALIZI, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	5216A LYNGATE CT
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-1631
Country	:	US
Telephone Number	:	703-978-7900
Fax Number	:	703-978-7985

Provider Business Practice Location Address
First Line	:	5216A LYNGATE CT
Second Line	:
City	:	BURKE
State	:	VA
Zip	:	22015-1631
Country	:	US
Telephone Number	:	703-978-7900
Fax Number	:	703-978-7985

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ALIREZA PALIZI
Credential	:	D.D.S
Telephone Number	:	703-978-7900

Provider Enumeration Date	:	04/08/2007
Last Update Date	:	08/22/2020

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