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Individual
DR. KEYOUMARS IZADI
Active
Individual
DR. KEYOUMARS IZADI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401412094
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
0438000243
VA
208200000X
Plastic Surgery Physician
0101243951
VA
Other
Enumeration date
08/28/2006
Last updated
06/30/2009
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