Provider Demographics
NPI:1982088381
Name:ZAKI, MADONNA (DDS)
Entity Type:Individual
Prefix:
First Name:MADONNA
Middle Name:
Last Name:ZAKI
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 1:2601 PARK CENTER DR.
Mailing Address - Street 2:C 305
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22302
Mailing Address - Country:US
Mailing Address - Phone:917-803-6308
Mailing Address - Fax:
Practice Address - Street 1:4435 BENNING RD., N.E.
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019
Practice Address - Country:US
Practice Address - Phone:917-226-6289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001519122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist