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
Fax: (703) 883-1114
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235128950 NPPES
Virginia MEDICAID 007819315

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