Healthcare Provider Details

I. General information

NPI: 1235065129
Provider Name (Legal Business Name): MUSTAFA ZAEEAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8404 OLD KEENE MILL RD
SPRINGFIELD VA
22152-2302
US

IV. Provider business mailing address

1545 WOODCREST DR
RESTON VA
20194-1558
US

V. Phone/Fax

Practice location:
  • Phone: 571-350-3556
  • Fax:
Mailing address:
  • Phone: 571-419-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401420065
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: