Healthcare Provider Details

I. General information

NPI: 1558935668
Provider Name (Legal Business Name): SYEDA AMNA ZAIM DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS SYEDA AMNA SHAH

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4152 DALE BLVD
WOODBRIDGE VA
22193-2225
US

IV. Provider business mailing address

4152 DALE BLVD
WOODBRIDGE VA
22193-2225
US

V. Phone/Fax

Practice location:
  • Phone: 571-650-1988
  • Fax: 571-650-1983
Mailing address:
  • Phone: 571-650-1988
  • Fax: 571-650-1983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401417634
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: