Provider Demographics
NPI:1790061695
Name:SALARI, MARJAN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:MARJAN
Middle Name:
Last Name:SALARI
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9455 DERAMUS FARM CT
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-1499
Mailing Address - Country:US
Mailing Address - Phone:240-441-2376
Mailing Address - Fax:
Practice Address - Street 1:6960G BRADLICK SHOPPING CTR # G
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-7227
Practice Address - Country:US
Practice Address - Phone:703-763-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014133621223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics