Provider Demographics
NPI:1437321940
Name:LALEH SARFARAZ, D.D.S., P.C.
Entity Type:Organization
Organization Name:LALEH SARFARAZ, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:SARFARAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-353-8890
Mailing Address - Street 1:12800 MIDDLEBROOK RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-5204
Mailing Address - Country:US
Mailing Address - Phone:301-353-8890
Mailing Address - Fax:301-515-9101
Practice Address - Street 1:12800 MIDDLEBROOK RD
Practice Address - Street 2:SUITE 104
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5204
Practice Address - Country:US
Practice Address - Phone:301-353-8890
Practice Address - Fax:301-515-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty