Healthcare Provider Details

I. General information

NPI: 1184360448
Provider Name (Legal Business Name): NAEEM MITCHELL MOTLAGH DMD, MDSC, FACP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8913 WOODYARD RD UNIT B
CLINTON MD
20735-4257
US

IV. Provider business mailing address

1501 CRYSTAL DR APT 722
ARLINGTON VA
22202-4161
US

V. Phone/Fax

Practice location:
  • Phone: 301-618-0067
  • Fax:
Mailing address:
  • Phone: 321-537-1865
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number18837
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: