Healthcare Provider Details

I. General information

NPI: 1508395609
Provider Name (Legal Business Name): SYEDA SAJIA ZAFRIN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2017
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16069 COMPRINT CIR
GAITHERSBURG MD
20877-1321
US

IV. Provider business mailing address

8050 MECHANICSVILLE TPKE UNIT 236
MECHANICSVILLE VA
23111-1263
US

V. Phone/Fax

Practice location:
  • Phone: 301-527-8480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number0401415684
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number17278
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: