Provider Demographics
NPI:1346319605
Name:KAZEMI, H RYAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:RYAN
Last Name:KAZEMI
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 1:4825 BETHESDA AVE
Mailing Address - Street 2:STE 310
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-654-7070
Mailing Address - Fax:301-654-7050
Practice Address - Street 1:4825 BETHESDA AVE
Practice Address - Street 2:STE 310
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-654-7070
Practice Address - Fax:301-654-7050
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD11793122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist