=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588767669
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FARID A ZURMATI DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/06/2006
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5960 KINGSTOWNE CENTER BLVD SUITE 140
-----------------------------------------------------
City | ALEXANDRIA
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 703-719-9210
-----------------------------------------------------
Fax | 703-719-6330
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2555 RESEARCH PARK DR
-----------------------------------------------------
City | DAVIS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95618-6143
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 571-426-4393
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208D00000X
-----------------------------------------------------
Taxonomy Name | General Practice Physician
-----------------------------------------------------
License Number | 101875
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------