Provider Demographics
NPI:1588843452
Name:RICHARD G TAMI DDS PC
Entity Type:Organization
Organization Name:RICHARD G TAMI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LEAD PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:TAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-491-2974
Mailing Address - Street 1:2200 OPITZ BLVD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191
Mailing Address - Country:US
Mailing Address - Phone:703-491-2974
Mailing Address - Fax:703-494-7570
Practice Address - Street 1:2200 OPITZ BLVD
Practice Address - Street 2:SUITE 205
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191
Practice Address - Country:US
Practice Address - Phone:703-491-2974
Practice Address - Fax:703-494-7570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD47161223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty