Healthcare Provider Details

I. General information

NPI: 1083280259
Provider Name (Legal Business Name): KOUROSH KARIMI DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2021
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-750-8718
  • Fax:
Mailing address:
  • Phone: 202-750-8718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: KOUROSH KARIMI
Title or Position: DOCTOR
Credential: DDS
Phone: 202-750-8718