Provider Demographics
NPI:1891081964
Name:G. GHAMARY DDS #1 PC
Entity Type:Organization
Organization Name:G. GHAMARY DDS #1 PC
Other - Org Name:CAPITAL DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GHAFOOR
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAMARY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:301-740-7500
Mailing Address - Street 1:19644 CLUB HOUSE RD STE 810
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3047
Mailing Address - Country:US
Mailing Address - Phone:301-740-7500
Mailing Address - Fax:301-740-7512
Practice Address - Street 1:19644 CLUB HOUSE RD STE 810
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3047
Practice Address - Country:US
Practice Address - Phone:301-740-7500
Practice Address - Fax:301-740-7512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD87951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty