Healthcare Provider Details

I. General information

NPI: 1700382926
Provider Name (Legal Business Name): ARLINGTON COSMETIC DENTAL GROUP, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 CLARENDON BLVD
ARLINGTON VA
22209-2741
US

IV. Provider business mailing address

1731 CLARENDON BLVD
ARLINGTON VA
22209-2741
US

V. Phone/Fax

Practice location:
  • Phone: 703-812-8800
  • Fax:
Mailing address:
  • Phone: 703-812-8800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PARASTOO FARHOODI KHAN
Title or Position: DENTIST
Credential: DDS
Phone: 703-812-8800