Provider Demographics
NPI:1710362629
Name:VAHID, SANAZ L (DDS)
Entity Type:Individual
Prefix:DR
First Name:SANAZ
Middle Name:L
Last Name:VAHID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7131 ARLINGTON RD APT 249
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2964
Mailing Address - Country:US
Mailing Address - Phone:703-655-5594
Mailing Address - Fax:
Practice Address - Street 1:4825 BETHESDA AVE STE 310
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-5245
Practice Address - Country:US
Practice Address - Phone:301-654-7070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-22
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163701223P0300X
VA0401414610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No122300000XDental ProvidersDentist