Provider Demographics
NPI:1144907031
Name:ALI, ZHANNA N
Entity type:Individual
Prefix:
First Name:ZHANNA
Middle Name:N
Last Name:ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:ZHANNA
Other - Middle Name:
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:14607 FEATHERSTONE GATE DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22191-3464
Mailing Address - Country:US
Mailing Address - Phone:571-332-0928
Mailing Address - Fax:
Practice Address - Street 1:12011 LEE JACKSON MEMORIAL HWY STE 502
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-3315
Practice Address - Country:US
Practice Address - Phone:703-268-5622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014184781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice