Provider Demographics
NPI:1548469794
Name:HAKIMELAHI, MOHAMMAD FARHAD (DDS)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:FARHAD
Last Name:HAKIMELAHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 ELDEN ST
Mailing Address - Street 2:SUITE # 201
Mailing Address - City:HERNDON
Mailing Address - State:VA
Mailing Address - Zip Code:20170
Mailing Address - Country:US
Mailing Address - Phone:703-435-7700
Mailing Address - Fax:703-435-7776
Practice Address - Street 1:625 ELDEN ST
Practice Address - Street 2:SUITE # 201
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4738
Practice Address - Country:US
Practice Address - Phone:703-435-7700
Practice Address - Fax:703-435-7776
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410285122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist