Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 0401412383 | VA |
N | 1223P0700X | Prosthodontist | 20173 | MA |
NPI | 1245376011 |
---|---|
Provider Name | Dr. Sassan Nadjmi |
First Address | Falls Church, VA 22046-3327 |
Second Address | Falls Church, VA 22046-3327 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2007 |
Last Update Date | 01/12/2010 |