Provider Demographics
NPI:1821978057
Name:MOUNT WASHINGTON ORTHODONTICS
Entity type:Organization
Organization Name:MOUNT WASHINGTON ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-884-9929
Mailing Address - Street 1:5042 DORSEY HALL DR STE 103
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 SULGRAVE AVE STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3650
Practice Address - Country:US
Practice Address - Phone:410-449-5488
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELLICOTT CITY ORTHODONTICS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty