Provider Demographics
NPI:1801071535
Name:BUTT, TEHREEM (DDS)
Entity type:Individual
Prefix:
First Name:TEHREEM
Middle Name:
Last Name:BUTT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10391 DEMOCRACY LN
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-2505
Mailing Address - Country:US
Mailing Address - Phone:908-787-4040
Mailing Address - Fax:775-402-9741
Practice Address - Street 1:10391 DEMOCRACY LN
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-2505
Practice Address - Country:US
Practice Address - Phone:908-787-4040
Practice Address - Fax:775-402-9741
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411341122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist