Healthcare Provider Details

I. General information

NPI: 1407534597
Provider Name (Legal Business Name): MOHAMMAD RAHIMI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8505 ARLINGTON BLVD
FAIRFAX VA
22031-4621
US

IV. Provider business mailing address

7910 S RUN VW
SPRINGFIELD VA
22153-3859
US

V. Phone/Fax

Practice location:
  • Phone: 703-705-2277
  • Fax:
Mailing address:
  • Phone: 703-945-2340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401419776
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: