Provider Demographics
NPI:1720134018
Name:RIZVI, ZIA SIBTAIN
Entity Type:Individual
Prefix:DR
First Name:ZIA
Middle Name:SIBTAIN
Last Name:RIZVI
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 1:42882 TRURO PARISH DR
Mailing Address - Street 2:SUITE #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:SUITE #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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014101571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice