Provider Demographics
NPI:1033277322
Name:ZAREI, MARYAM A (DDS)
Entity Type:Individual
Prefix:
First Name:MARYAM
Middle Name:A
Last Name:ZAREI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9097 ATLEE STATION RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116
Mailing Address - Country:US
Mailing Address - Phone:804-559-3250
Mailing Address - Fax:804-559-3342
Practice Address - Street 1:9097 ATLEE STATION RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116
Practice Address - Country:US
Practice Address - Phone:804-559-3250
Practice Address - Fax:804-559-3342
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist