Provider Demographics
NPI:1023340189
Name:YAGHMAI, PEDRAM (DDS)
Entity type:Individual
Prefix:DR
First Name:PEDRAM
Middle Name:
Last Name:YAGHMAI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 VILLA DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15214-1468
Mailing Address - Country:US
Mailing Address - Phone:412-867-1678
Mailing Address - Fax:
Practice Address - Street 1:19440 GOLF VISTA PLZ
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176-8263
Practice Address - Country:US
Practice Address - Phone:703-858-5990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-31
Last Update Date:2010-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014124081223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery