Provider Demographics
NPI:1356734230
Name:PARIZADEH, PARDIS (DDS)
Entity type:Individual
Prefix:
First Name:PARDIS
Middle Name:
Last Name:PARIZADEH
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 1:2518 FARRINGDON RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2548
Mailing Address - Country:US
Mailing Address - Phone:410-989-5115
Mailing Address - Fax:
Practice Address - Street 1:4 SUDBROOK LN STE 1B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-4117
Practice Address - Country:US
Practice Address - Phone:410-989-5115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-16
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD163261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics