Provider Demographics
NPI:1821149980
Name:JAFARI, HODA (DDS)
Entity Type:Individual
Prefix:DR
First Name:HODA
Middle Name:
Last Name:JAFARI
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 1:200 FORBES ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1538
Mailing Address - Country:US
Mailing Address - Phone:443-603-9000
Mailing Address - Fax:443-603-9000
Practice Address - Street 1:200 FORBES ST
Practice Address - Street 2:SUITE 301
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1538
Practice Address - Country:US
Practice Address - Phone:443-603-9000
Practice Address - Fax:443-603-9000
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12683122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist