Avanti Specialty Pllc is a dental clinic (Dentist - General Practice) in Tysons Corner, Virginia. The current practice location for Avanti Specialty Pllc is 1500 Cornerside Blvd Ste 500, Tysons Corner, Virginia. For appointments, you can reach them via phone at
(703) 625-6229. The mailing address for Avanti Specialty Pllc is 1500 Cornerside Blvd Ste 500, Tysons Corner, Virginia and phone number is (703) 625-6229.
Avanti Specialty Pllc is licensed to practice in Virginia (license number 0401004998) and its
NPI number is 1215382262. This medical practice
does not participate in medicare program and thus may not accept your medicare insurance. You may check if they accept your insurance at
(703) 625-6229.
Dental Care Clinic Profile
| Full Name | Avanti Specialty Pllc |
|---|
| Speciality | Dentist - General Practice |
|---|
| Location | 1500 Cornerside Blvd Ste 500, Tysons Corner, Virginia |
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| Authorized Official Name and Position | Farshad Farhoumand (OWNER) |
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| Authorized Official Contact | 7036256229 |
|---|
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Avanti Specialty Pllc
1500 Cornerside Blvd Ste 500
Tysons Corner
VA 22182-2440
Ph: (703) 625-6229 | Avanti Specialty Pllc
1500 Cornerside Blvd Ste 500
Tysons Corner
VA 22182-2440
Ph: (703) 625-6229 |
NPI Details:
| NPI Number | 1215382262 |
|---|
| Provider Enumeration Date | 04/27/2016 |
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| Last Update Date | 04/27/2016 |
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Medical Identifiers
Medical identifiers for Avanti Specialty Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215382262 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | 0438000311 (Virginia) | Secondary |
| 1223E0200X | Dentist - Endodontics | 0401411183 (Virginia) | Secondary |
| 1223P0300X | Dentist - Periodontics | 0401412973 (Virginia) | Secondary |
| 1223P0700X | Dentist - Prosthodontics | 0401414238 (Virginia) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 0438000311 (Virginia) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401413394 (Virginia) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 0401413955 (Virginia) | Secondary |
| 1223G0001X | Dentist - General Practice | 0401004998 (Virginia) | Primary |
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