Provider Demographics
NPI:1285750588
Name:BEHNIA, ALI (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:ALI
Middle Name:
Last Name:BEHNIA
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9707 KEY WEST AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3992
Mailing Address - Country:US
Mailing Address - Phone:301-340-9494
Mailing Address - Fax:301-340-9348
Practice Address - Street 1:9707 KEY WEST AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3992
Practice Address - Country:US
Practice Address - Phone:301-340-9494
Practice Address - Fax:301-340-9348
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121171223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics