Provider Demographics
NPI:1699868869
Name:AMOUHASHEM, PARVIN (DDS)
Entity type:Individual
Prefix:
First Name:PARVIN
Middle Name:
Last Name:AMOUHASHEM
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 1:3817A S GEORGE MASON DR
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-3763
Mailing Address - Country:US
Mailing Address - Phone:703-575-9700
Mailing Address - Fax:703-575-9889
Practice Address - Street 1:3817A S GEORGE MASON DR
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-3763
Practice Address - Country:US
Practice Address - Phone:703-575-9700
Practice Address - Fax:703-575-9889
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010075021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice