Provider Demographics
NPI:1316010630
Name:LEINER, ZACHARY (DDS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:LEINER
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 1:9401 LEE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1849
Mailing Address - Country:US
Mailing Address - Phone:703-273-6011
Mailing Address - Fax:703-273-5933
Practice Address - Street 1:9401 LEE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-1849
Practice Address - Country:US
Practice Address - Phone:703-273-6011
Practice Address - Fax:703-273-5933
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA48411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice