Provider Demographics
NPI:1376204388
Name:ZOOGY DENTAL COMPANY PLLC
Entity Type:Organization
Organization Name:ZOOGY DENTAL COMPANY PLLC
Other - Org Name:HERITAGE DENTAL ARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PERVAIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-349-0099
Mailing Address - Street 1:7120 HERITAGE VILLAGE PLZ STE 101
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3068
Mailing Address - Country:US
Mailing Address - Phone:703-349-0099
Mailing Address - Fax:
Practice Address - Street 1:7120 HERITAGE VILLAGE PLZ STE 101
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3068
Practice Address - Country:US
Practice Address - Phone:703-349-0099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty