Provider Demographics
NPI:1689747412
Name:MEHDI ADILI DDS PC
Entity Type:Organization
Organization Name:MEHDI ADILI DDS PC
Other - Org Name:IDEAL DENTAL SOLUTION
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER PROSTHODONTICS
Authorized Official - Prefix:MRS
Authorized Official - First Name:MEHDI
Authorized Official - Middle Name:S
Authorized Official - Last Name:ADILI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-442-0442
Mailing Address - Street 1:8353 A GREENSBORO DR
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102
Mailing Address - Country:US
Mailing Address - Phone:703-442-0442
Mailing Address - Fax:703-442-0498
Practice Address - Street 1:8353 A GREENSBORO DR
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22102
Practice Address - Country:US
Practice Address - Phone:703-442-0442
Practice Address - Fax:703-442-0498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
Not Answered1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty