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NPI Code Detail

MEDICARE: OVERLEA DENTAL INC.

MEDICARE: OVERLEA DENTAL INC.
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1225757222
Entity Type Code : Organization
Provider Name (Legal Business Name) : OVERLEA DENTAL INC.
Provider Business Mailing Address
First Line : 6411 BELAIR RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21206-1822
Country : US
Telephone Number : 410-254-8624
Fax Number :
Provider Business Practice Location Address
First Line : 6411 BELAIR RD
Second Line :
City : BALTIMORE
State : MD
Zip : 21206-1822
Country : US
Telephone Number : 410-254-8624
Fax Number : 410-254-8670
Authorized Official
Title or Position : OWNER
Name : DR. SHEIDA NAKHAEI
Credential : DDS
Telephone Number : 410-254-8624
Provider Enumeration Date : 08/23/2022
Last Update Date : 08/29/2022

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Directions to “OVERLEA DENTAL INC. ” Practice Location

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