Provider Demographics
NPI:1780748970
Name:VAJDI, MEHRDAD (DDS)
Entity type:Individual
Prefix:DR
First Name:MEHRDAD
Middle Name:
Last Name:VAJDI
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 1:908 NEW HAMPSHIRE AVE NW
Mailing Address - Street 2:#100
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-2346
Mailing Address - Country:US
Mailing Address - Phone:202-822-3787
Mailing Address - Fax:202-822-3747
Practice Address - Street 1:908 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:#100
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-2346
Practice Address - Country:US
Practice Address - Phone:202-822-3787
Practice Address - Fax:202-822-3747
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC5025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist