Provider Demographics
NPI:1366958654
Name:PCD ORTHODONTICS, LLC
Entity type:Organization
Organization Name:PCD ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FARIBA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARYAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-683-8040
Mailing Address - Street 1:11904-D DARNESTOWN ROAD
Mailing Address - Street 2:
Mailing Address - City:NORTH POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20878
Mailing Address - Country:US
Mailing Address - Phone:240-683-8040
Mailing Address - Fax:240-683-8041
Practice Address - Street 1:11904-D DARNESTOWN ROAD
Practice Address - Street 2:
Practice Address - City:NORTH POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20878
Practice Address - Country:US
Practice Address - Phone:240-683-8040
Practice Address - Fax:240-683-8041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty