Provider Demographics
NPI:1417290305
Name:GREENBELT FAMILY DENTISTRY
Entity Type:Organization
Organization Name:GREENBELT FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYED HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:TOFIGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-474-9100
Mailing Address - Street 1:7500 HANOVER PKWY
Mailing Address - Street 2:106
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-2010
Mailing Address - Country:US
Mailing Address - Phone:301-474-9100
Mailing Address - Fax:301-474-1660
Practice Address - Street 1:7500 HANOVER PKWY
Practice Address - Street 2:106
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-2010
Practice Address - Country:US
Practice Address - Phone:301-474-9100
Practice Address - Fax:301-474-1660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115541223G0001X, 1223P0221X
MD136261223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1558350298Medicaid