# F. IRAVANI DMD PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tysons Dental Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770591695
- **Authorized official:** DR. FARIDEM IRAVANI DMD (DENTIST/PROVIDER/OWNER)
- **Authorized official phone:** (703) 848-8448

## Contact information

- **Practice address:** 1964 GALLOWS RD, STE 220, VIENNA, VA 22182-3814
- **Practice address phone:** (703) 848-8448
- **Practice address fax:** (703) 848-8448
- **Mailing address:** 1964 GALLOWS RD, STE 220, VIENNA, VA 22182-3814
- **Mailing address phone:** (703) 848-8448
- **Mailing address fax:** (703) 848-8448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 0401008961 | VA | Yes |

## Other

- **Enumeration date:** 08/04/2006
- **Last updated:** 08/22/2020