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General NPI Number Information
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NPI Number | 1245376011
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Entity Type | Individual
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Provider Name | SASSAN NADJMI DMD
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/01/2010
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Provider Practice Location Address
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Address Line | 313 PARK AVE SUITE #306
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3327
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Country | US
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Telephone | 703-532-7586
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Fax |
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Provider Business Mailing Address
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Address Line | 313 PARK AVE SUITE #306
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3327
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Country | US
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Telephone | 703-532-7586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 20173
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 0401412383
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License Number State | VA
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