Provider Demographics
NPI:1922898824
Name:RAHELEH MAKHMALBAF DMD LLC
Entity type:Organization
Organization Name:RAHELEH MAKHMALBAF DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAHELEH
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKHMALBAF
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:404-723-6643
Mailing Address - Street 1:174 THOMAS JOHNSON DR STE 200
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4579
Mailing Address - Country:US
Mailing Address - Phone:301-695-9446
Mailing Address - Fax:
Practice Address - Street 1:174 THOMAS JOHNSON DR STE 200
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4579
Practice Address - Country:US
Practice Address - Phone:301-695-9446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental