Provider Demographics
NPI:1952491474
Name:AGHAEE & NOURI, DDS, PC
Entity Type:Organization
Organization Name:AGHAEE & NOURI, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TRESURER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:R
Authorized Official - Last Name:AGHAEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-404-9111
Mailing Address - Street 1:46175 WESTLAKE DR STE 220
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5884
Mailing Address - Country:US
Mailing Address - Phone:703-404-9111
Mailing Address - Fax:703-404-4181
Practice Address - Street 1:46175 WESTLAKE DR STE 220
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5884
Practice Address - Country:US
Practice Address - Phone:703-404-9111
Practice Address - Fax:703-404-4181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010081081223G0001X
VA04010083211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty