NPI 1609357235 · live from the CMS NPI Registry
Advanced Dental Anesthesia PLLC
Anesthesiology in Fairfax, VA. National Provider Identifier 1609357235, active.
NPI record
| NPI | 1609357235 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology 207L00000X |
| Practice location | 10611 Braddock Rd, Fairfax, VA 22032 |
| Practice phone | 202-265-0805 |
| Mailing address | 2776 S Arlington Mill Dr # 121, Arlington, VA 22206 |
| Enumerated | August 22, 2018 |
| Last updated | August 22, 2018 |
| Authorized official | Reza Izadi, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Anesthesiology primary | 207L00000X | FI5268405 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.