Provider Demographics
NPI:1073144226
Name:MAI ZAMAKHCHARI DMD PLLC
Entity Type:Organization
Organization Name:MAI ZAMAKHCHARI DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSURANCE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-459-0511
Mailing Address - Street 1:2740 HILL RD
Mailing Address - Street 2:
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22181-5322
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8719 STONEWALL RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4534
Practice Address - Country:US
Practice Address - Phone:703-368-1000
Practice Address - Fax:703-331-4944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental