MEDICARE: SUZAN DEHBASHI

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	DDS104506	CA

General Provider Information

NPI Number	:	1437610821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZAN DEHBASHI

Provider Business Mailing Address
First Line	:	7920 LEWINSVILLE RD
Second Line	:
City	:	MC LEAN
State	:	VA
Zip	:	22102-2407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 WILSON BLVD
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22203-4417
Country	:	US
Telephone Number	:	212-686-3686
Fax Number	:

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

Provider Enumeration Date	:	03/27/2019
Last Update Date	:	01/30/2026

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Directions to “ SUZAN DEHBASHI ” Practice Location

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