Provider Demographics
NPI:1356164214
Name:ARIA DENTAL SPA, LLC
Entity type:Organization
Organization Name:ARIA DENTAL SPA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUJAHIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHMOODI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:571-242-0162
Mailing Address - Street 1:50 DUNN DR STE 105
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22556-1500
Mailing Address - Country:US
Mailing Address - Phone:571-242-0162
Mailing Address - Fax:
Practice Address - Street 1:50 DUNN DR STE 105
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22556-1500
Practice Address - Country:US
Practice Address - Phone:571-242-0162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty