| Kambiz And Kamran Tavakkoli Dmd, Pc | |
|
12500 Lake Ridge Dr Woodbridge VA 22192-2354 | |
| (703) 494-3176 | |
| (703) 494-8207 |
| Full Name | Kambiz And Kamran Tavakkoli Dmd, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12500 Lake Ridge Dr, Woodbridge, Virginia |
| Authorized Official Name and Position | Kambiz Tavakkoli (DOCTOR) |
| Authorized Official Contact | 7034943176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kambiz And Kamran Tavakkoli Dmd, Pc 12500 Lake Ridge Dr Woodbridge VA 22192-2354 Ph: (703) 494-3176 | Kambiz And Kamran Tavakkoli Dmd, Pc 12500 Lake Ridge Dr Woodbridge VA 22192-2354 Ph: (703) 494-3176 |
| NPI Number | 1497871057 |
|---|---|
| Provider Enumeration Date | 03/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497871057 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0401410837 (Virginia) | Primary |
| 1223G0001X | Dentist - General Practice | 0401410838 (Virginia) | Secondary |
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