Provider Demographics
NPI:1881972578
Name:GHESMATI-KALURAZI, AZIN (DDS)
Entity type:Individual
Prefix:DR
First Name:AZIN
Middle Name:
Last Name:GHESMATI-KALURAZI
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 1:2201 N ST NW
Mailing Address - Street 2:APT 316
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1107
Mailing Address - Country:US
Mailing Address - Phone:917-880-5844
Mailing Address - Fax:
Practice Address - Street 1:1426 21ST ST NW
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5947
Practice Address - Country:US
Practice Address - Phone:202-331-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist