Provider Demographics
NPI:1184117202
Name:RAZMGAR, CYRUS MARTIN (DDS)
Entity type:Individual
Prefix:
First Name:CYRUS
Middle Name:MARTIN
Last Name:RAZMGAR
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 1:4706 RIPPLING POND DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-5081
Mailing Address - Country:US
Mailing Address - Phone:703-599-1024
Mailing Address - Fax:703-818-9728
Practice Address - Street 1:5012 TALMADGE RD STE 100
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-2168
Practice Address - Country:US
Practice Address - Phone:419-474-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.025457122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist