Provider Demographics
NPI:1366740706
Name:HEDYEH ATASHBAR, DDS, LLC
Entity type:Organization
Organization Name:HEDYEH ATASHBAR, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEDYEH
Authorized Official - Middle Name:
Authorized Official - Last Name:ATASHBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-593-0060
Mailing Address - Street 1:11213 LOCKWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901
Mailing Address - Country:US
Mailing Address - Phone:301-593-0060
Mailing Address - Fax:301-593-0067
Practice Address - Street 1:11213 LOCKWOOD DRIVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20901
Practice Address - Country:US
Practice Address - Phone:301-593-0060
Practice Address - Fax:301-593-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-09
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9220303Medicaid