Provider Demographics
NPI:1932893989
Name:NOVA CENTER FOR PERIODONTICS AND DENTAL IMPLANTS
Entity Type:Organization
Organization Name:NOVA CENTER FOR PERIODONTICS AND DENTAL IMPLANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SYEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAFRIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:703-507-8648
Mailing Address - Street 1:3166 GOLANSKY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4263
Mailing Address - Country:US
Mailing Address - Phone:703-730-2931
Mailing Address - Fax:
Practice Address - Street 1:3166 GOLANSKY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4263
Practice Address - Country:US
Practice Address - Phone:703-730-2931
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty