# GHAZAL GHASSEMI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1134715261
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401418728 | VA | Yes |
| 1223P0700X | Prosthodontics | IP2001 | WV | — |

## Other

- **Enumeration date:** 12/13/2020
- **Last updated:** 08/30/2024