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General NPI Number Information
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NPI Number | 1659627123
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Entity Type | Individual
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Provider Name | DR. MARYAM BEMANI
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Gender | Female
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 7305 BALTIMORE AVE STE 204
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City | COLLEGE PARK
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State | MD
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Zip | 20740-3232
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Country | US
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Telephone | 301-927-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 6127 WHITE MARBLE CT
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City | CLARKSVILLE
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State | MD
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Zip | 21029-1658
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Country | US
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Telephone | 410-531-5050
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 15152
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15152
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License Number State | MD
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