MEDICARE: DR. ROBERT BABAK MARZBAN DDS MDS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	0401410032	VA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	056091-1	NY

General Provider Information

NPI Number	:	1053503151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BABAK MARZBAN DDS MDS

Provider Business Mailing Address
First Line	:	6715 WHITTIER AVE STE 100
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-4502
Country	:	US
Telephone Number	:	703-356-8781
Fax Number	:

Provider Business Practice Location Address
First Line	:	6715 WHITTIER AVE STE 100
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22101-4502
Country	:	US
Telephone Number	:	703-356-8781
Fax Number	:	703-442-4868

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

Provider Enumeration Date	:	08/13/2007
Last Update Date	:	06/02/2025

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