Provider Demographics
NPI:1265691521
Name:RASTEGARI, AKRAM (DDS)
Entity type:Individual
Prefix:DR
First Name:AKRAM
Middle Name:
Last Name:RASTEGARI
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 1:5415 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2765
Mailing Address - Country:US
Mailing Address - Phone:202-362-4710
Mailing Address - Fax:202-362-5807
Practice Address - Street 1:5415 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2765
Practice Address - Country:US
Practice Address - Phone:202-362-4710
Practice Address - Fax:202-362-5807
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN4010122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist