MEDICARE: DR. AKRAM RASTEGARI 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	122300000X	Dentist	DEN4010	DC

General Provider Information

NPI Number	:	1265691521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AKRAM RASTEGARI DDS

Provider Business Mailing Address
First Line	:	5415 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20015-2765
Country	:	US
Telephone Number	:	202-362-4710
Fax Number	:	202-362-5807

Provider Business Practice Location Address
First Line	:	5415 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20015-2765
Country	:	US
Telephone Number	:	202-362-4710
Fax Number	:	202-362-5807

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

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	06/03/2008

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