Provider Demographics
NPI:1124200431
Name:PASHAPOUR, ALI (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:PASHAPOUR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3158 GOLANSKY BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4262
Mailing Address - Country:US
Mailing Address - Phone:703-223-2678
Mailing Address - Fax:
Practice Address - Street 1:1016 N HIGHLAND ST
Practice Address - Street 2:STE 131B
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-2112
Practice Address - Country:US
Practice Address - Phone:703-223-2678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014118541223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery