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General NPI Number Information
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NPI Number | 1679631980
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Entity Type | Organization
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Legal Business Name | NADER REZVANI D.D.S., P.C.
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 908 NEW HAMPSHIRE AVE NW SUITE 301
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City | WASHINGTON
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State | DC
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Zip | 20037-2346
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Country | US
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Telephone | 202-457-0070
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Fax | 202-457-0029
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Provider Business Mailing Address
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Address Line | 908 NEW HAMPSHIRE AVE NW SUITE 301
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City | WASHINGTON
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State | DC
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Zip | 20037-2346
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Country | US
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Telephone | 202-457-0070
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Fax | 202-457-0029
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Authorized Official
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Title or Position | PRESIDENT
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Name | NADER REZVANI
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Credential | D.D.S.
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Telephone | 202-457-0070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401008527
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License Number State | VA
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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 | DEN4636
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License Number State | DC
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