Provider Demographics
NPI:1972830289
Name:ZIAFAT, LEYLA SARAH (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEYLA
Middle Name:SARAH
Last Name:ZIAFAT
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 1:1013 DAIRY ASHFORD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079
Mailing Address - Country:US
Mailing Address - Phone:832-230-5222
Mailing Address - Fax:832-200-3161
Practice Address - Street 1:1013 DAIRY ASHFORD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079
Practice Address - Country:US
Practice Address - Phone:832-230-5222
Practice Address - Fax:832-200-3161
Is Sole Proprietor?:No
Enumeration Date:2009-11-06
Last Update Date:2015-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23607122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2059933-03Medicaid