Provider Demographics
NPI:1326376237
Name:KAMANGAR, NADIA
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:KAMANGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2943 OLNEY SANDY SPRING RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2943 OLNEY SANDY SPRING RD
Practice Address - Street 2:SUITE D
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1525
Practice Address - Country:US
Practice Address - Phone:301-774-0600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD141501223G0001X
DCDEN10007501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice