Provider Demographics
NPI:1215085741
Name:NAWAZ, MIRWEISS (DDS)
Entity type:Individual
Prefix:DR
First Name:MIRWEISS
Middle Name:
Last Name:NAWAZ
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 1:46179 WESTLAKE DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5874
Mailing Address - Country:US
Mailing Address - Phone:703-430-3838
Mailing Address - Fax:703-430-8851
Practice Address - Street 1:46179 WESTLAKE DR
Practice Address - Street 2:SUITE 230
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5874
Practice Address - Country:US
Practice Address - Phone:703-430-3838
Practice Address - Fax:703-430-8851
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014103011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice