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General NPI Number Information
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NPI Number | 1073997748
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Entity Type | Individual
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Provider Name | MARIAM NAEEM DMD
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Gender | Female
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Dates
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Enumeration Date | 07/13/2015
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 100 SPECTRUM CENTER DR SUITE 1500
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City | IRVINE
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State | CA
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Zip | 92618-4962
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Country | US
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Telephone | 714-668-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 2230 GALLOWS RD SUIT 320
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City | DUNN LORING
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State | VA
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Zip | 22027-1101
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Country | US
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Telephone | 703-573-8664
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS040539
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | VA 0401414993
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License Number State | VA
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