Individual
TINA ABOLGHASEMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14337 NEWBROOK DR STE 200, CHANTILLY, VA 20151-4259
(703) 214-2113
Mailing address
700 N RANDOLPH ST APT 1112, ARLINGTON, VA 22203-2187
(202) 669-5299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401419593
VA
Other
Enumeration date
08/28/2025
Last updated
08/28/2025
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