Provider Demographics
NPI:1053668939
Name:MAZHARI, SHEILA N (DMD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:N
Last Name:MAZHARI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6671B BACKLICK RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2702
Mailing Address - Country:US
Mailing Address - Phone:703-992-7050
Mailing Address - Fax:703-992-1456
Practice Address - Street 1:6671B BACKLICK RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150-2702
Practice Address - Country:US
Practice Address - Phone:703-992-7050
Practice Address - Fax:703-992-1456
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413677122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist