Provider Demographics
NPI:1588758247
Name:MIRMONSEF, PARASTU (DDS)
Entity type:Individual
Prefix:DR
First Name:PARASTU
Middle Name:
Last Name:MIRMONSEF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2303 N PARHAM RD STE 5
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-3102
Mailing Address - Country:US
Mailing Address - Phone:804-346-9049
Mailing Address - Fax:
Practice Address - Street 1:2303 N PARHAM RD STE 5
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-3102
Practice Address - Country:US
Practice Address - Phone:804-346-9049
Practice Address - Fax:804-747-0119
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000095861223G0001X
VA04014121501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice