Provider Demographics
NPI:1215669486
Name:PARASTU MIRMONSEF, DDS, PLLC
Entity type:Organization
Organization Name:PARASTU MIRMONSEF, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PARASTU
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRMONSEF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-475-3362
Mailing Address - Street 1:2303 N PARHAM RD STE 5
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-3102
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2303 N PARHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-3102
Practice Address - Country:US
Practice Address - Phone:804-346-9049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-27
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty