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General NPI Number Information
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NPI Number | 1760675797
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Entity Type | Organization
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Legal Business Name | SHAHRAM SABET DDS, PC
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Dates
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Enumeration Date | 08/22/2007
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Last Update Date | 08/22/2007
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Provider Practice Location Address
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Address Line | 360 MAPLE AVE W STE C
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City | VIENNA
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State | VA
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Zip | 22180-5614
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Country | US
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Telephone | 703-281-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 360 MAPLE AVE W STE C
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City | VIENNA
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State | VA
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Zip | 22180-5614
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Country | US
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Telephone | 703-281-1311
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAHRAM SABET
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Credential | DDS
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Telephone | 703-281-1311
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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 | 0401410366
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License Number State | VA
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