Provider Demographics
NPI:1013417641
Name:VAZIRI-LENJANI, SHAHRAM (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAHRAM
Middle Name:
Last Name:VAZIRI-LENJANI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11414 EMERALD PARK RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1167
Mailing Address - Country:US
Mailing Address - Phone:619-717-1661
Mailing Address - Fax:
Practice Address - Street 1:11404 OLD GEORGETOWN RD STE 206
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2892
Practice Address - Country:US
Practice Address - Phone:301-244-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2025-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA428951223P0300X
MD175131223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics