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General NPI Number Information
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NPI Number | 1306622014
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Entity Type | Organization
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Legal Business Name | LANSDOWNE PEDIATRIC DENTISTRY
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Dates
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Enumeration Date | 09/07/2023
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 19415 DEERFIELD AVE STE 304
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City | LANSDOWNE
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State | VA
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Zip | 20176-8472
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Country | US
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Telephone | 517-210-2771
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Fax | 571-210-0606
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Provider Business Mailing Address
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Address Line | 9632 FIELDS RD
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City | GAITHERSBURG
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State | MD
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Zip | 20878-4738
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Country | US
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Telephone | 703-728-5798
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Fax |
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. SHEYDA MAGHSOUDI
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Credential | DDS
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Telephone | 703-728-5798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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