Healthcare Provider Details

I. General information

NPI: 1407778145
Provider Name (Legal Business Name): LEILA MOVAHEDI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 E WEST HWY
SILVER SPRING MD
20910-3230
US

IV. Provider business mailing address

5901 MONTROSE RD
NORTH BETHESDA MD
20852-4753
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-6804
  • Fax:
Mailing address:
  • Phone: 301-529-2910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18904
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: