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General NPI Number Information
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NPI Number | 1649331349
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Entity Type | Organization
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Legal Business Name | DR DEHYAR AND ASSOC DMD PC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9534 BURKE ROAD
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City | BURKE
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State | VA
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Zip | 22015
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Country | US
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Telephone | 703-764-0650
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Fax | 703-764-1772
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Provider Business Mailing Address
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Address Line | 9534 BURKE ROAD
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City | BURKE
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State | VA
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Zip | 22015
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Country | US
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Telephone | 703-764-0650
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Fax | 703-764-1772
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Authorized Official
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Title or Position | DOCTOR
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Name | JOSEPH DEHYAR
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Credential | DMD
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Telephone | 703-764-0650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401411034
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License Number State | VA
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