Provider Demographics
NPI:1831423144
Name:ARAMESH DARVISHIAN DDS
Entity type:Organization
Organization Name:ARAMESH DARVISHIAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:DARVISHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-955-4440
Mailing Address - Street 1:12040 S LAKES DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-1246
Mailing Address - Country:US
Mailing Address - Phone:703-955-4440
Mailing Address - Fax:703-880-7970
Practice Address - Street 1:12040 S LAKES DR
Practice Address - Street 2:SUITE 200
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-1246
Practice Address - Country:US
Practice Address - Phone:703-955-4440
Practice Address - Fax:703-880-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-21
Last Update Date:2009-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410794122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty