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General NPI Number Information
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NPI Number | 1891509725
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Entity Type | Organization
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Legal Business Name | DAVARY & SMITH ORAL & MAXILLOFACIAL SURGERY & DENTAL IMPLANT CENTER, PLLC
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 21351 GENTRY DR STE 115
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City | STERLING
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State | VA
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Zip | 20166-8510
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Country | US
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Telephone | 703-740-8848
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Fax |
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Provider Business Mailing Address
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Address Line | 21351 GENTRY DR STE 115
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City | STERLING
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State | VA
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Zip | 20166-8510
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Country | US
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Telephone | 703-740-8848
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ASHKAN DAVARY DOWLATABADY
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Credential | MD, DDS
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Telephone | 703-740-8848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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