Provider Demographics
NPI:1114595444
Name:AZIMAIE, TAHA (MS, DMD, MSE)
Entity Type:Individual
Prefix:DR
First Name:TAHA
Middle Name:
Last Name:AZIMAIE
Suffix:
Gender:M
Credentials:MS, DMD, MSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 ELSMERE CT
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1601
Mailing Address - Country:US
Mailing Address - Phone:415-623-8609
Mailing Address - Fax:
Practice Address - Street 1:8500 ANNAPOLIS RD STE 209
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3022
Practice Address - Country:US
Practice Address - Phone:240-582-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI028417001223G0001X
DCDEN20002241223G0001X
MD178101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice