Provider Demographics
NPI:1790187516
Name:NAVID ASGARI
Entity Type:Organization
Organization Name:NAVID ASGARI
Other - Org Name:ALEXANDRIA DENTAL ART
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVI
Authorized Official - Middle Name:AMIN
Authorized Official - Last Name:ASGARI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, PC
Authorized Official - Phone:703-556-8799
Mailing Address - Street 1:1001 N FAIRFAX ST STE 100
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-1798
Mailing Address - Country:US
Mailing Address - Phone:703-566-8799
Mailing Address - Fax:703-313-7004
Practice Address - Street 1:1001 N FAIRFAX ST STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1798
Practice Address - Country:US
Practice Address - Phone:703-566-8799
Practice Address - Fax:703-313-7004
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY DENTISTRY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401008923122300000X
VA0401410470122300000X
VA0401413354122300000X
VA04014139821223P0300X
VA04380001591223S0112X
VA04014114461223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty