Provider Demographics
NPI:1366504268
Name:GOLESTANI, PARASTOO (DDS)
Entity Type:Individual
Prefix:
First Name:PARASTOO
Middle Name:
Last Name:GOLESTANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20010 CENTURY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1118
Mailing Address - Country:US
Mailing Address - Phone:301-972-1600
Mailing Address - Fax:301-972-3644
Practice Address - Street 1:20010 CENTURY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1118
Practice Address - Country:US
Practice Address - Phone:703-433-0234
Practice Address - Fax:703-433-0598
Is Sole Proprietor?:No
Enumeration Date:2006-12-15
Last Update Date:2018-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice