Farh Alam Zada, DDS
Individual provider Active NPI Dentist · Manassas, VA
NPI 1093480071 · NPPES record last updated Aug 12, 2021
Key facts
- NPI
- 1093480071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 0401417641 (VA)
- Practice address
- 10630 Crestwood Dr Ste B
Manassas, VA 20109-4405 - Phone
- (703) 574-0971
- NPI assigned
- Aug 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401417641 | VA | MD | Dentist |
Networks
- Freedom Health HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 0401417641 | VA | Yes |
Addresses
Primary practice location
10630 Crestwood Dr Ste B
Manassas, VA 20109-4405
Mailing address
2975 Hunters Branch Rd Unit 121
Fairfax, VA 22031-6066
Other practice location 1
3114 Golansky Blvd Ste 101
Woodbridge, VA 22192-4231
Phone (703) 584-5028
Other providers in Manassas, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.