Provider Demographics
NPI:1124271572
Name:RIZVI, SYED SAJJAD (DDS)
Entity type:Individual
Prefix:MR
First Name:SYED
Middle Name:SAJJAD
Last Name:RIZVI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44936 PARKMEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-6535
Mailing Address - Country:US
Mailing Address - Phone:510-824-8948
Mailing Address - Fax:
Practice Address - Street 1:44936 PARKMEADOW DR
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-6535
Practice Address - Country:US
Practice Address - Phone:510-824-8948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA578251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice