Healthcare Provider Details

I. General information

NPI: 1023945144
Provider Name (Legal Business Name): GHAZAL ASHRAFZADEH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7885 NORMANDY BLVD
JACKSONVILLE FL
32221-6640
US

IV. Provider business mailing address

900 RIGGINS RD APT 726
TALLAHASSEE FL
32308-2220
US

V. Phone/Fax

Practice location:
  • Phone: 904-783-1633
  • Fax:
Mailing address:
  • Phone: 248-675-7058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: