# AVANTI SPECIALTY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215382262
- **Authorized official:** DR. FARSHAD FARHOUMAND (OWNER)
- **Authorized official phone:** (703) 625-6229

## Contact information

- **Practice address:** 1500 CORNERSIDE BLVD STE 500, TYSONS CORNER, VA 22182-2440
- **Practice address phone:** (703) 625-6229
- **Practice address fax:** (703) 821-0692
- **Mailing address:** 1500 CORNERSIDE BLVD STE 500, TYSONS CORNER, VA 22182-2440
- **Mailing address phone:** (703) 625-6229
- **Mailing address fax:** (703) 821-0692

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0004X | Dental Anesthesiology | 0438000311 | VA | — |
| 1223E0200X | Endodontics | 0401411183 | VA | — |
| 1223G0001X | General Practice Dentistry | 0401004998 | VA | Yes |
| 1223P0300X | Periodontics | 0401412973 | VA | — |
| 1223P0700X | Prosthodontics | 0401414238 | VA | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 0438000311 | VA | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 0401413394 | VA | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | 0401413955 | VA | — |

## Other

- **Enumeration date:** 04/27/2016
- **Last updated:** 04/27/2016