Provider Demographics
NPI:1316552409
Name:IFTIKHAR, ZUBIA (BDS)
Entity Type:Individual
Prefix:DR
First Name:ZUBIA
Middle Name:
Last Name:IFTIKHAR
Suffix:
Gender:F
Credentials:BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 BODWELL TER
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1201
Mailing Address - Country:US
Mailing Address - Phone:317-658-5089
Mailing Address - Fax:
Practice Address - Street 1:326 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5602
Practice Address - Country:US
Practice Address - Phone:718-618-7564
Practice Address - Fax:718-618-7566
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2022-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416116122300000X
NY0614631223X2210X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223X2210XDental ProvidersDentistOrofacial Pain