Maryam Ebrahimzadeh, LAC

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

U02547 Issued in MD

Practice address

11870 Grand Park Ave
North Bethesda, MD 20852-8690

Phone

(443) 474-5295

NPI assigned

Dec 28, 2018

Last updated

Dec 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1487126546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11870 GRAND PARK AVE",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208528690",
            "telephone_number": "443-474-5295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11870 GRAND PARK AVE",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208528690",
            "telephone_number": "443-474-5295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIMZADEH",
        "first_name": "MARYAM",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-28",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U02547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Acupuncturist in North Bethesda, MD
• Providers in North Bethesda, MD by specialty
• Acupuncturist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.