Provider Demographics
NPI:1215281944
Name:BAHREMAND, MOJDE (OD)
Entity type:Individual
Prefix:
First Name:MOJDE
Middle Name:
Last Name:BAHREMAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 N FAIRFAX ST APT 703
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-5550
Mailing Address - Country:US
Mailing Address - Phone:703-780-7324
Mailing Address - Fax:703-780-0973
Practice Address - Street 1:7910 RICHMOND HWY
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22306
Practice Address - Country:US
Practice Address - Phone:703-780-7324
Practice Address - Fax:703-780-0973
Is Sole Proprietor?:No
Enumeration Date:2012-11-02
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002446152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist