Provider Demographics
NPI:1962811950
Name:ZAIBER, ANSAM (DDS)
Entity type:Individual
Prefix:
First Name:ANSAM
Middle Name:
Last Name:ZAIBER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANSAM
Other - Middle Name:
Other - Last Name:PAULUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1693 BURNTWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-1507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1693 BURNTWOOD CT
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-1507
Practice Address - Country:US
Practice Address - Phone:202-431-4884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-05
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414583122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist