Provider Demographics
NPI:1194913590
Name:TEHRANI, NEGAR S (DMD)
Entity type:Individual
Prefix:DR
First Name:NEGAR
Middle Name:S
Last Name:TEHRANI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6870 ELM ST
Mailing Address - Street 2:SUITE #300
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-3893
Mailing Address - Country:US
Mailing Address - Phone:703-748-1900
Mailing Address - Fax:703-748-1901
Practice Address - Street 1:6870 ELM ST
Practice Address - Street 2:SUITE #300
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3893
Practice Address - Country:US
Practice Address - Phone:703-748-1900
Practice Address - Fax:703-748-1901
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-10
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411943122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist