Provider Demographics
NPI:1376697615
Name:ZIER, TARA L (DDS)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:L
Last Name:ZIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8996 BURKE LAKE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1607
Mailing Address - Country:US
Mailing Address - Phone:703-764-7800
Mailing Address - Fax:703-764-9045
Practice Address - Street 1:8996 BURKE LAKE RD STE 200
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:VA
Practice Address - Zip Code:22015-1607
Practice Address - Country:US
Practice Address - Phone:703-764-7800
Practice Address - Fax:703-764-9045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010086921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0401008692OtherLICENSE NUMBER