MEDICARE: ROGHIEH ATAPOUR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12619	MD

General Provider Information

NPI Number	:	1003948704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGHIEH ATAPOUR DDS

Provider Business Mailing Address
First Line	:	9520 BERGER RD
Second Line	:	STE 105
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1554
Country	:	US
Telephone Number	:	410-730-6666
Fax Number	:	410-730-3501

Provider Business Practice Location Address
First Line	:	9520 BERGER RD STE 105
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21046-1554
Country	:	US
Telephone Number	:	410-730-6666
Fax Number	:	410-730-3501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	04/25/2024

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