Provider Demographics
NPI:1932240983
Name:KAZEMIFAR, ASGHAR (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASGHAR
Middle Name:
Last Name:KAZEMIFAR
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 1:11119 ROCKVILLE PIKE
Mailing Address - Street 2:400A
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3143
Mailing Address - Country:US
Mailing Address - Phone:301-984-7572
Mailing Address - Fax:301-984-7157
Practice Address - Street 1:11119 ROCKVILLE PIKE
Practice Address - Street 2:400A
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3143
Practice Address - Country:US
Practice Address - Phone:301-984-7572
Practice Address - Fax:301-984-7157
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08540122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist