Provider Demographics
NPI:1477592772
Name:ESFANDIARI, SHEILA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:
Last Name:ESFANDIARI
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 1:50 W EDMONSTON DR STE 205
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1250
Mailing Address - Country:US
Mailing Address - Phone:301-424-1402
Mailing Address - Fax:301-424-1403
Practice Address - Street 1:50 W EDMONSTON DR STE 205
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1250
Practice Address - Country:US
Practice Address - Phone:301-424-1401
Practice Address - Fax:301-424-1403
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD118001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics