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General NPI Number Information
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NPI Number | 1881779791
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Entity Type | Individual
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Provider Name | YEKTA DIANATNEJAD D.D.S
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4808 DEL RAY AVE
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City | BETHESDA
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State | MD
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Zip | 20814-3014
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Country | US
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Telephone | 301-652-6100
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Fax | 301-652-2005
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Provider Business Mailing Address
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Address Line | 4808 DEL RAY AVE
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City | BETHESDA
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State | MD
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Zip | 20814-3014
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Country | US
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Telephone | 301-652-6100
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Fax | 301-652-2005
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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 | 11902
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License Number State | MD
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