Provider Demographics
NPI:1629561501
Name:BAGHERI & WHYNOTT PLC
Entity Type:Organization
Organization Name:BAGHERI & WHYNOTT PLC
Other - Org Name:HOLLYMEAD DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:AREZOO
Authorized Official - Last Name:BAGHERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:434-242-6707
Mailing Address - Street 1:1538 INSURANCE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-7229
Mailing Address - Country:US
Mailing Address - Phone:434-973-4649
Mailing Address - Fax:434-973-4877
Practice Address - Street 1:1538 INSURANCE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-7229
Practice Address - Country:US
Practice Address - Phone:434-973-4649
Practice Address - Fax:434-973-4877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-14
Last Update Date:2018-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty