Provider Demographics
NPI:1770858235
Name:ARLINGTON ADVANCED DENTAL CARE
Entity Type:Organization
Organization Name:ARLINGTON ADVANCED DENTAL CARE
Other - Org Name:HOSSEIN AHMADIAN LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HOSSEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-436-8689
Mailing Address - Street 1:1010 N GLEBE RD
Mailing Address - Street 2:120
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22201-4749
Mailing Address - Country:US
Mailing Address - Phone:703-436-8689
Mailing Address - Fax:
Practice Address - Street 1:1010 N GLEBE RD
Practice Address - Street 2:120
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-4749
Practice Address - Country:US
Practice Address - Phone:703-436-8689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014110441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty