Provider Demographics
NPI:1437303450
Name:GHAFARI, CHITRA (DDS)
Entity type:Individual
Prefix:
First Name:CHITRA
Middle Name:
Last Name:GHAFARI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MARKET ST
Mailing Address - Street 2:SUITE 209
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6548
Mailing Address - Country:US
Mailing Address - Phone:240-631-9363
Mailing Address - Fax:
Practice Address - Street 1:60 MARKET ST
Practice Address - Street 2:SUITE 209
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-6548
Practice Address - Country:US
Practice Address - Phone:240-631-9363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD135211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice