Provider Demographics
NPI:1073703906
Name:KAZEMIFAR, HODA (DMD)
Entity Type:Individual
Prefix:DR
First Name:HODA
Middle Name:
Last Name:KAZEMIFAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 GOLDEN WOODS CT
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-4152
Mailing Address - Country:US
Mailing Address - Phone:703-244-4355
Mailing Address - Fax:
Practice Address - Street 1:11119 ROCKVILLE PIKE STE 400A
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:703-244-4355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2008-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAMA21914122300000X
MD14154122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist