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General NPI Number Information
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NPI Number | 1154606242
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Entity Type | Individual
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Provider Name | MOHAMMED A. ALMZAYYEN DDS
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Gender | Male
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Dates
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Enumeration Date | 10/20/2011
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 335 GREENBRIER DRIVE SUITE: 204
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901
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Country | US
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Telephone | 703-212-7500
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Fax | 703-212-7056
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Provider Business Mailing Address
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Address Line | 335 GREENBRIER DR STE 204
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City | CHARLOTTESVILLE
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State | VA
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Zip | 22901-1695
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Country | US
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Telephone | 434-296-5250
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Fax | 434-296-5946
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0401413310
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License Number State | VA
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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 | 0401413310
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License Number State | VA
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