Provider Demographics
NPI:1952689150
Name:ZAKI ORTHODONTICS
Entity Type:Organization
Organization Name:ZAKI ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAREK
Authorized Official - Middle Name:O
Authorized Official - Last Name:ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-416-1100
Mailing Address - Street 1:2029 LYNNHAVEN PKWY
Mailing Address - Street 2:SUITE 700
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-1474
Mailing Address - Country:US
Mailing Address - Phone:757-416-1100
Mailing Address - Fax:757-416-1130
Practice Address - Street 1:2029 LYNNHAVEN PKWY
Practice Address - Street 2:SUITE 700
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-1474
Practice Address - Country:US
Practice Address - Phone:757-416-1100
Practice Address - Fax:757-416-1130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-22
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010068041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty