MEDICARE: DR. ARASH KYLE MEHRNAMA D.D.S.

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	0401414794	VA
2	122300000X	Dentist	15743	MD

General Provider Information

NPI Number	:	1376959817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARASH KYLE MEHRNAMA D.D.S.

Provider Business Mailing Address
First Line	:	7600 HANOVER PKWY
Second Line	:	200
City	:	GREENBELT
State	:	MD
Zip	:	20770-2008
Country	:	US
Telephone Number	:	301-474-1110
Fax Number	:

Provider Business Practice Location Address
First Line	:	7600 HANOVER PKWY
Second Line	:	200
City	:	GREENBELT
State	:	MD
Zip	:	20770-2008
Country	:	US
Telephone Number	:	301-474-1110
Fax Number	:

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

Provider Enumeration Date	:	07/04/2014
Last Update Date	:	04/24/2017

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