Provider Demographics
NPI:1629700646
Name:FERESHTEH JARVANDI DDS PC
Entity Type:Organization
Organization Name:FERESHTEH JARVANDI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FERESHTEH
Authorized Official - Middle Name:
Authorized Official - Last Name:JARVANDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-271-9828
Mailing Address - Street 1:4712 RICHMOND HWY STE A
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-3162
Mailing Address - Country:US
Mailing Address - Phone:804-271-9828
Mailing Address - Fax:804-433-3107
Practice Address - Street 1:4712 RICHMOND HWY STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234-3162
Practice Address - Country:US
Practice Address - Phone:804-271-9828
Practice Address - Fax:804-433-3107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental