Provider Demographics
NPI:1154606242
Name:ALMZAYYEN, MOHAMMED A (DDS)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:A
Last Name:ALMZAYYEN
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 1:335 GREENBRIER DR STE 204
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1695
Mailing Address - Country:US
Mailing Address - Phone:434-296-5250
Mailing Address - Fax:434-296-5946
Practice Address - Street 1:335 GREENBRIER DRIVE
Practice Address - Street 2:SUITE: 204
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901
Practice Address - Country:US
Practice Address - Phone:703-212-7500
Practice Address - Fax:703-212-7056
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2019-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014133101223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice