Mortazie, Mansour
Mortazie, Mansour is an sole proprietor health care provider with primary practice located at 313 Park Ave Suite 302, Falls Church VA 22046-3327. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Mortazie, Mansour can be contacted via phone (703) 237-0662.Contact Information
Primary practice address
313 Park Ave Suite 302
Falls Church VA 22046-3327
Phone: (703) 237-0662
Fax: (703) 883-1114
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 0401005721 | Virginia |
Profile Details
| NPI number | 1235128950 |
|---|---|
| LBN Legal business name | Mortazie, Mansour |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 15th, 2005 |
| Last updated | Mar 12th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235128950 | NPPES |
| Virginia | MEDICAID | 007819315 |
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