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General NPI Number Information
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NPI Number | 1194862169
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Entity Type | Organization
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Legal Business Name | SASAN AHMADIYAR DDS & ASSOCIATES
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 385 GARRISONVILLE RD SUITE 108
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City | STAFFORD
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State | VA
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Zip | 22554-1545
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Country | US
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Telephone | 540-657-7645
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Fax | 540-657-1009
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Provider Business Mailing Address
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Address Line | 385 GARRISONVILLE RD SUITE 108
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City | STAFFORD
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State | VA
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Zip | 22554-1545
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Country | US
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Telephone | 540-657-7645
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Fax | 540-657-1009
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | AHMIR SAEID AHMADIYAR
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Credential |
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Telephone | 540-657-7645
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 0401008083
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License Number State | VA
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