MEDICARE: MALAIKA SHAHZADI SOHAIL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	0401419605	VA

General Provider Information

NPI Number	:	1962381426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALAIKA SHAHZADI SOHAIL DDS

Provider Business Mailing Address
First Line	:	1312 DOMINION LAKES BLVD
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-6451
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2537 JOHN MILTON DR
Second Line	:
City	:	HERNDON
State	:	VA
Zip	:	20171-2527
Country	:	US
Telephone Number	:	703-259-8477
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2025
Last Update Date	:	08/28/2025

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