Provider Demographics
NPI:1467832741
Name:DR. FARHAN M. QURESHI DDS PC
Entity Type:Organization
Organization Name:DR. FARHAN M. QURESHI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARHAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-931-4544
Mailing Address - Street 1:5206 DAWES AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1404
Mailing Address - Country:US
Mailing Address - Phone:703-931-4544
Mailing Address - Fax:703-820-8737
Practice Address - Street 1:5206 DAWES AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1404
Practice Address - Country:US
Practice Address - Phone:703-931-4544
Practice Address - Fax:703-820-8737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-02
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411638122300000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty