MEDICARE: DR. FATEMEH BAFTECHI DMD

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	0401416289	VA

General Provider Information

NPI Number	:	1346723939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FATEMEH BAFTECHI DMD

Provider Business Mailing Address
First Line	:	45589 SHEPARD DR
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4409
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	45589 SHEPARD DR
Second Line	:
City	:	STERLING
State	:	VA
Zip	:	20164-4409
Country	:	US
Telephone Number	:	703-962-7009
Fax Number	:

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	09/11/2018

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