Provider Demographics
NPI:1447948187
Name:SAFADI, YAMEN (DDS)
Entity type:Individual
Prefix:DR
First Name:YAMEN
Middle Name:
Last Name:SAFADI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4211 RIDGE TOP RD APT 4303
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-1112
Mailing Address - Country:US
Mailing Address - Phone:443-447-4487
Mailing Address - Fax:
Practice Address - Street 1:8056 ROLLING RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22153-2928
Practice Address - Country:US
Practice Address - Phone:571-648-0038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALT-0004101223P0700X
DCDLT20000061223P0700X
VA04014185781223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics