Healthcare Provider Details

I. General information

NPI: 1548104425
Provider Name (Legal Business Name): NEJLA DZAFIC DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2149 BARRACKS RD
CHARLOTTESVILLE VA
22903-4810
US

IV. Provider business mailing address

4938 N TALMAN AVE
CHICAGO IL
60625-8109
US

V. Phone/Fax

Practice location:
  • Phone: 434-424-0285
  • Fax:
Mailing address:
  • Phone: 773-747-1104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401420045
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: