Provider Demographics
NPI:1619606910
Name:SPRINGFIELD HEALTHY SMILES
Entity Type:Organization
Organization Name:SPRINGFIELD HEALTHY SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPLE
Authorized Official - Prefix:DR
Authorized Official - First Name:FARINAZ
Authorized Official - Middle Name:
Authorized Official - Last Name:NIROUMAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:408-306-6842
Mailing Address - Street 1:8338 TRAFORD LN
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1638
Mailing Address - Country:US
Mailing Address - Phone:703-866-7000
Mailing Address - Fax:
Practice Address - Street 1:8338 TRAFORD LN
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1638
Practice Address - Country:US
Practice Address - Phone:703-866-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental