Healthcare Provider Details

I. General information

NPI: 1134551823
Provider Name (Legal Business Name): ZUBAD NEWAZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/05/2013
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3109 SAWGRASS VILLAGE CIR
PONTE VEDRA BEACH FL
32082-5032
US

IV. Provider business mailing address

3109 SAWGRASS VILLAGE CIR
PONTE VEDRA BEACH FL
32082-5032
US

V. Phone/Fax

Practice location:
  • Phone: 904-273-9115
  • Fax: 904-871-8117
Mailing address:
  • Phone: 904-273-9115
  • Fax: 904-871-8117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN20311
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: