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General NPI Number Information
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NPI Number | 1952491474
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Entity Type | Organization
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Legal Business Name | AGHAEE & NOURI, DDS, PC
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 11/25/2008
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Provider Practice Location Address
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Address Line | 46175 WESTLAKE DR STE 220
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City | STERLING
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State | VA
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Zip | 20165-5884
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Country | US
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Telephone | 703-404-9111
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Fax | 703-404-4181
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Provider Business Mailing Address
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Address Line | 46175 WESTLAKE DR STE 220
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City | STERLING
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State | VA
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Zip | 20165-5884
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Country | US
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Telephone | 703-404-9111
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Fax | 703-404-4181
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Authorized Official
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Title or Position | TRESURER
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Name | DR. ALI R AGHAEE
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Credential | DDS
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Telephone | 703-404-9111
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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 | 0401008108
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401008321
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License Number State | VA
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