Provider Demographics
NPI:1447652268
Name:MY FACE MY SMILE
Entity type:Organization
Organization Name:MY FACE MY SMILE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHROKH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLTANI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:202-452-8989
Mailing Address - Street 1:2055 L ST NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-4983
Mailing Address - Country:US
Mailing Address - Phone:202-452-8989
Mailing Address - Fax:202-452-6814
Practice Address - Street 1:2055 L ST NW
Practice Address - Street 2:SUITE 100
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-4983
Practice Address - Country:US
Practice Address - Phone:202-452-8989
Practice Address - Fax:202-452-6814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001168261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental