Provider Demographics
NPI:1629048160
Name:MEYMAND, SAMIRA (DDS/MPH)
Entity Type:Individual
Prefix:DR
First Name:SAMIRA
Middle Name:
Last Name:MEYMAND
Suffix:
Gender:F
Credentials:DDS/MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10624 KENILWORTH AVE
Mailing Address - Street 2:UNIT 202
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4268
Mailing Address - Country:US
Mailing Address - Phone:214-394-5923
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVENUE
Practice Address - Street 2:ORAL AND MAXILLOFACIAL SURGERY DEPARTMENT
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4340
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48512122300000X
TX20454122300000X
GADN012747122300000X
VA0401410993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered122300000XDental ProvidersDentist