Provider Demographics
NPI:1508531187
Name:HARANDI, ASHKAN
Entity Type:Individual
Prefix:DR
First Name:ASHKAN
Middle Name:
Last Name:HARANDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E WEST HWY APT 712
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-6275
Mailing Address - Country:US
Mailing Address - Phone:443-745-8023
Mailing Address - Fax:
Practice Address - Street 1:1215 E WEST HWY APT 712
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-6275
Practice Address - Country:US
Practice Address - Phone:443-745-8023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-15
Last Update Date:2021-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014174631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice