Healthcare Provider Details

I. General information

NPI: 1659045102
Provider Name (Legal Business Name): NARMIN SADAT HEJAZIFAR DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2021
Last Update Date: 08/06/2021
Certification Date: 08/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 SOUR CHERRY CT
NORTH POTOMAC MD
20878-4711
US

IV. Provider business mailing address

4 SOUR CHERRY CT
NORTH POTOMAC MD
20878-4711
US

V. Phone/Fax

Practice location:
  • Phone: 703-894-7491
  • Fax:
Mailing address:
  • Phone: 703-894-7491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17533
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: