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General NPI Number Information
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NPI Number | 1669823027
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Entity Type | Individual
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Provider Name | KIANOUSH ALEM D.M.D., M.S.
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 2440 M ST NW SUITE 608
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City | WASHINGTON
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State | DC
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Zip | 20037-1404
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Country | US
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Telephone | 202-822-3785
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Fax | 202-822-9096
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Provider Business Mailing Address
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Address Line | 2440 M ST NW SUITE 608
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City | WASHINGTON
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State | DC
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Zip | 20037-1404
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Country | US
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Telephone | 202-822-3785
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Fax | 202-822-9096
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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 | 4802
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License Number State | DC
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