Provider Demographics
NPI:1114139813
Name:HESSAMFAR, RAMIN (DMD, MS, PC)
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:
Last Name:HESSAMFAR
Suffix:
Gender:M
Credentials:DMD, MS, PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42882 TRURO PARISH DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4456
Mailing Address - Country:US
Mailing Address - Phone:703-726-6561
Mailing Address - Fax:703-726-6562
Practice Address - Street 1:42882 TRURO PARISH DR
Practice Address - Street 2:SUITE 210
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4456
Practice Address - Country:US
Practice Address - Phone:703-726-6561
Practice Address - Fax:703-726-6562
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014106701223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics