Provider Demographics
NPI:1043377989
Name:MIAMEE, GOLNAZ (DDS)
Entity Type:Individual
Prefix:
First Name:GOLNAZ
Middle Name:
Last Name:MIAMEE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11490 COMMERCE PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1532
Mailing Address - Country:US
Mailing Address - Phone:703-498-2507
Mailing Address - Fax:
Practice Address - Street 1:11490 COMMERCE PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1532
Practice Address - Country:US
Practice Address - Phone:703-498-2507
Practice Address - Fax:571-350-3046
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014107501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice