Provider Demographics
NPI:1487330080
Name:GHAMARY, SAHAR ROSE (DMD)
Entity type:Individual
Prefix:DR
First Name:SAHAR
Middle Name:ROSE
Last Name:GHAMARY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19644 CLUB HOUSE RD STE 810
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3048
Mailing Address - Country:US
Mailing Address - Phone:301-300-6072
Mailing Address - Fax:
Practice Address - Street 1:19644 CLUB HOUSE RD STE 810
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-3048
Practice Address - Country:US
Practice Address - Phone:703-945-9696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD180571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice