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General NPI Number Information
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NPI Number | 1841925419
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Entity Type | Individual
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Provider Name | DARAKSHAN FATMI DDS
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Gender | Female
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Dates
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Enumeration Date | 07/19/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | 3728 CRAIN HWY UNIT 105
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City | WALDORF
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State | MD
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Zip | 20603-4888
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Country | US
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Telephone | 240-448-2634
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Fax |
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Provider Business Mailing Address
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Address Line | 1716 M ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-2008
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DEN2000147
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License Number State | DC
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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 | 17794
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License Number State | MD
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