Provider Demographics
NPI:1992379168
Name:DREAM SMILES PEDIATRIC DENTISTRY OF GAITHERSBURG
Entity Type:Organization
Organization Name:DREAM SMILES PEDIATRIC DENTISTRY OF GAITHERSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FIROUZEH
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMSHIDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:617-763-2002
Mailing Address - Street 1:818 W DIAMOND AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-1458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:818 W DIAMOND AVE STE 220
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-1458
Practice Address - Country:US
Practice Address - Phone:617-763-2002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental