Healthcare Provider Details

I. General information

NPI: 1295929859
Provider Name (Legal Business Name): XINSHENG ZHU D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17606 MAIN ST SUITE 200
DUMFRIES VA
22026-2343
US

IV. Provider business mailing address

17606 MAIN ST SUITE 200
DUMFRIES VA
22026-2343
US

V. Phone/Fax

Practice location:
  • Phone: 703-445-1999
  • Fax:
Mailing address:
  • Phone: 703-445-1999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401411645
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: