| Maryam Avin DDS PC | |
|
19366 Diamond Lake Dr Leesburg VA 20176-6574 | |
| (703) 687-3255 | |
| (703) 687-3246 |
| Full Name | Maryam Avin DDS PC |
|---|---|
| Speciality | Clinic/Center |
| Location | 19366 Diamond Lake Dr, Leesburg, Virginia |
| Authorized Official Name and Position | Maryam Avin (OWNER) |
| Authorized Official Contact | 7036873255 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maryam Avin DDS PC 19366 Diamond Lake Dr Leesburg VA 20176-6574 Ph: (703) 687-3255 | Maryam Avin DDS PC 19366 Diamond Lake Dr Leesburg VA 20176-6574 Ph: (703) 687-3255 |
| NPI Number | 1396538377 |
|---|---|
| Provider Enumeration Date | 05/23/2025 |
| Last Update Date | 05/30/2025 |
| Certification Date | 05/30/2025 |
| Medicare PECOS PAC ID | 3274033899 |
|---|---|
| Medicare Enrollment ID | O20250826004442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396538377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (NU) | Primary |
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