Provider Demographics
NPI:1073997748
Name:NAEEM, MARIAM (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARIAM
Middle Name:
Last Name:NAEEM
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 1:2230 GALLOWS RD
Mailing Address - Street 2:SUIT 320
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-1101
Mailing Address - Country:US
Mailing Address - Phone:703-573-8664
Mailing Address - Fax:
Practice Address - Street 1:100 SPECTRUM CENTER DR
Practice Address - Street 2:SUITE 1500
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-4962
Practice Address - Country:US
Practice Address - Phone:714-668-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040539122300000X
VAVA 0401414993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist