Provider Demographics
NPI:1619355385
Name:INTERGRITY DENTAL INC.
Entity Type:Organization
Organization Name:INTERGRITY DENTAL INC.
Other - Org Name:DULLES DENTAL
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADZADA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:703-802-8999
Mailing Address - Street 1:5103 WESTFIELDS BLVD
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-4365
Mailing Address - Country:US
Mailing Address - Phone:703-802-8999
Mailing Address - Fax:703-802-4704
Practice Address - Street 1:5103 WESTFIELDS BLVD
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20120-4365
Practice Address - Country:US
Practice Address - Phone:703-802-8999
Practice Address - Fax:703-802-4704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410639122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty