Provider Demographics
NPI:1619269669
Name:SHEIDA LARIJANI DDS LLC
Entity Type:Organization
Organization Name:SHEIDA LARIJANI DDS LLC
Other - Org Name:BETHESDA DENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LARIJANI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-654-2157
Mailing Address - Street 1:14031 BERRYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-3519
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7978 OLD GEORGETOWN RD
Practice Address - Street 2:6C
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2479
Practice Address - Country:US
Practice Address - Phone:301-654-2157
Practice Address - Fax:301-654-2938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty