Provider Demographics
NPI:1184903676
Name:SINGH, FARAH ASSADIPOUR (DMD,)
Entity type:Individual
Prefix:DR
First Name:FARAH
Middle Name:ASSADIPOUR
Last Name:SINGH
Suffix:
Gender:F
Credentials:DMD,
Other - Prefix:
Other - First Name:FARAH
Other - Middle Name:
Other - Last Name:ASSADIPOUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:5454 WISCONSIN AVENUE, SUITE 1355
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815
Mailing Address - Country:US
Mailing Address - Phone:301-654-1818
Mailing Address - Fax:
Practice Address - Street 1:5802 HUBBARD DRIVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852
Practice Address - Country:US
Practice Address - Phone:301-984-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1855776122300000X
MDDR152751223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist