Provider Demographics
NPI:1184794562
Name:JAHANMIR, GOLNAR (DDS)
Entity type:Individual
Prefix:DR
First Name:GOLNAR
Middle Name:
Last Name:JAHANMIR
Suffix:
Gender:F
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:NIH/NIDCR DENTAL CLINIC
Mailing Address - Street 2:10 CENTER DRIVE, BLDG 10, RM 1B15
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-6259
Mailing Address - Country:US
Mailing Address - Phone:301-443-8010
Mailing Address - Fax:
Practice Address - Street 1:9210 CORPORATE BLVD STE 430
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6259
Practice Address - Country:US
Practice Address - Phone:301-990-0892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-09
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN10003831223P0221X
VA04014116141223P0221X
MD131711223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry