Maryam Ashraghi
Individual provider Active NPI Dentist · MC Lean, VA
NPI 1508364977 · NPPES record last updated Aug 17, 2020
Key facts
- NPI
- 1508364977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401415925 (VA)
- Practice address
- 1524 Lincoln Way Unit 433
MC Lean, VA 22102-5946 - Phone
- (508) 246-9093
- NPI assigned
- Jan 31, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401415925 | VA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alpine Dental Care | Dentist | Current |
Accepting new patients |
| Sam E English II DDS LTD | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401415925 | VA | Yes |
Addresses
Primary practice location
1524 Lincoln Way Unit 433
MC Lean, VA 22102-5946
Mailing address
1524 Lincoln Way Unit 433
MC Lean, VA 22102-5946
Phone (508) 246-9093
Other practice location 1
7210 Old Keene Mill Rd
Springfield, VA 22150-3442
Phone (703) 644-7300
Other practice location 2
1524 Lincoln Way Unit 433
Mc Lean, VA 22102-5946
Other providers in MC Lean, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.