Provider Demographics
NPI:1700385184
Name:SNOOZE DENTAL CARE PLLC
Entity type:Organization
Organization Name:SNOOZE DENTAL CARE PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZEYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:MADY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:703-379-6400
Mailing Address - Street 1:5284 DAWES AVE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311-1404
Mailing Address - Country:US
Mailing Address - Phone:703-379-6400
Mailing Address - Fax:703-376-6407
Practice Address - Street 1:5284 DAWES AVE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311-1404
Practice Address - Country:US
Practice Address - Phone:703-379-6400
Practice Address - Fax:703-376-6407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAVA04010061641223G0001X
VAVA04014157811223G0001X
VAVA04014116111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1831245075OtherDENTIST
VA1922467190OtherDENTIST
VA1962560920OtherDENTIST