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General NPI Number Information
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NPI Number | 1710362629
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Entity Type | Individual
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Provider Name | SANAZ L VAHID D.D.S
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Gender | Female
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Dates
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Enumeration Date | 07/22/2015
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 4825 BETHESDA AVE STE 310
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City | BETHESDA
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State | MD
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Zip | 20814-5245
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Country | US
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Telephone | 301-654-7070
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Fax |
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Provider Business Mailing Address
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Address Line | 7131 ARLINGTON RD APT 249
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City | BETHESDA
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State | MD
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Zip | 20814-2964
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Country | US
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Telephone | 703-655-5594
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 16370
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401414610
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License Number State | VA
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