Provider Demographics
NPI:1588209886
Name:SEPIDEH BADRIAHARI, DDS, PLLC
Entity Type:Organization
Organization Name:SEPIDEH BADRIAHARI, DDS, PLLC
Other - Org Name:DENTAL STUDIO AT MARK CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEPIDEH
Authorized Official - Middle Name:
Authorized Official - Last Name:BADRI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-778-1221
Mailing Address - Street 1:1466 N BEAUREGARD ST STE B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-5800
Mailing Address - Country:US
Mailing Address - Phone:703-778-1221
Mailing Address - Fax:703-578-3022
Practice Address - Street 1:1466 N BEAUREGARD ST STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-5800
Practice Address - Country:US
Practice Address - Phone:703-778-1221
Practice Address - Fax:703-578-3022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-10
Last Update Date:2023-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental