Provider Demographics
NPI:1710592522
Name:TALMAZOV, GEORGI
Entity Type:Individual
Prefix:
First Name:GEORGI
Middle Name:
Last Name:TALMAZOV
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:GEORGI
Other - Middle Name:
Other - Last Name:TALMAZOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8500 ANNAPOLIS RD STE 209
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3022
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4400 JENIFER ST NW STE 220
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2087
Practice Address - Country:US
Practice Address - Phone:202-244-2101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36537122300000X
VA0401416687122300000X
DCDEN20001791223P0700X
MD18315122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty