Healthcare Provider Details

I. General information

NPI: 1184117202
Provider Name (Legal Business Name): CYRUS MARTIN RAZMGAR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5012 TALMADGE RD STE 100
TOLEDO OH
43623-2168
US

IV. Provider business mailing address

4706 RIPPLING POND DR
FAIRFAX VA
22033-5081
US

V. Phone/Fax

Practice location:
  • Phone: 419-474-9611
  • Fax:
Mailing address:
  • Phone: 703-599-1024
  • Fax: 703-818-9728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025457
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number064560
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: