Individual provider Active NPI

Fridoun Pishdad, DMD

  • Dentist
  • Potomac, MD
National Provider Identifier
1134282668
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8479 Issued in MD
Practice address
10000 Falls Road
Suite 301
Potomac, MD 20854
Phone
(301) 983-2165
Fax
(301) 299-0560
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 8479 MD Primary

Addresses

Primary practice location

10000 Falls Road
Suite 301
Potomac, MD 20854

Mailing address

10000 Falls Road
Suite 301
Potomac, MD 20854
Phone (301) 983-2165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8479MDMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134282668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10000 FALLS ROAD",
            "address_2": "SUITE 301",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "20854",
            "telephone_number": "301-983-2165",
            "fax_number": "301-299-0560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 FALLS ROAD",
            "address_2": "SUITE 301",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "20854",
            "telephone_number": "301-983-2165",
            "fax_number": "301-299-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PISHDAD",
        "first_name": "FRIDOUN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "8479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.