Provider Demographics
NPI:1598188807
Name:SAJJADI, PARVANEH (DDS)
Entity Type:Individual
Prefix:
First Name:PARVANEH
Middle Name:
Last Name:SAJJADI
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 1:5862 HUBBARD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4820
Mailing Address - Country:US
Mailing Address - Phone:301-984-4040
Mailing Address - Fax:301-984-4419
Practice Address - Street 1:5862 HUBBARD DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-4820
Practice Address - Country:US
Practice Address - Phone:301-984-4040
Practice Address - Fax:301-984-4419
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD138851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice