Provider Demographics
NPI:1831656826
Name:KIDZ & FAMILY DENTAL CENTER LLC
Entity Type:Organization
Organization Name:KIDZ & FAMILY DENTAL CENTER LLC
Other - Org Name:KIDZ & FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PARISA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEMATI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-200-8015
Mailing Address - Street 1:11933 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-2001
Mailing Address - Country:US
Mailing Address - Phone:301-200-8015
Mailing Address - Fax:240-833-2558
Practice Address - Street 1:1350 HOLTON LN
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-7510
Practice Address - Country:US
Practice Address - Phone:301-200-8015
Practice Address - Fax:240-833-2558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-26
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty