FARZAD KOOSHA DDS NPI 1154996049

NPI Information

Farzad Koosha, DDS is a student in an organized health care education training program in Alexandria, VA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. Farzad Koosha, DDS NPI is 1154996049. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6357 BURGUNDY LEAF LN
ALEXANDRIA, VA
ZIP 22312-918
Phone: (202) 820-1090

The enumeration date for this NPI number is 5/24/2021 and was last updated on 5/24/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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