Provider Demographics
NPI:1700398989
Name:NAYYAR, MUHAMMAD USMAN
Entity Type:Individual
Prefix:
First Name:MUHAMMAD USMAN
Middle Name:
Last Name:NAYYAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9494 BANKHEAD DR
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-8315
Mailing Address - Country:US
Mailing Address - Phone:703-789-7616
Mailing Address - Fax:
Practice Address - Street 1:3400 PAYNE ST STE 101
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-2313
Practice Address - Country:US
Practice Address - Phone:703-578-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-28
Last Update Date:2017-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014158751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice