Provider Demographics
NPI:1588013056
Name:SWAYNE, YELIZ OZER (DDS)
Entity Type:Individual
Prefix:DR
First Name:YELIZ
Middle Name:OZER
Last Name:SWAYNE
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 1:6116 ROLLING RD STE 316
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22152-1512
Mailing Address - Country:US
Mailing Address - Phone:703-451-8332
Mailing Address - Fax:
Practice Address - Street 1:6116 ROLLING RD STE 316
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22152-1512
Practice Address - Country:US
Practice Address - Phone:703-451-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014155421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice