Provider Demographics
NPI:1710308051
Name:ZIA RIZVI DDS PC
Entity Type:Organization
Organization Name:ZIA RIZVI DDS PC
Other - Org Name:ASHBURN DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-858-1904
Mailing Address - Street 1:42882 TRURO PARISH DR
Mailing Address - Street 2:208
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4456
Mailing Address - Country:US
Mailing Address - Phone:703-858-1904
Mailing Address - Fax:703-858-0840
Practice Address - Street 1:42882 TRURO PARISH DR
Practice Address - Street 2:208
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4456
Practice Address - Country:US
Practice Address - Phone:703-858-1904
Practice Address - Fax:703-858-0840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2014-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401410157122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1720134018OtherNPI