Derakhshan, Mitra

Derakhshan, Mitra is an individual health care provider with primary practice located at 5082 Dorsey Hall Dr Ste 202 , Ellicott City MD 21042-7754. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Derakhshan, Mitra can be contacted via phone (202) 445-4972.

Contact Information

Primary practice address
5082 Dorsey Hall Dr Ste 202 Ellicott City MD 21042-7754
Phone: (202) 445-4972
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DEN1000677 District of Columbia
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 49090 California
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 12731 Maryland

Profile Details

NPI number 1962916783
LBN Legal business name Derakhshan, Mitra
Credentials DDS MS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2017
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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