Provider Demographics
NPI:1366603110
Name:FREED, TINGTING ZHU (DMD)
Entity type:Individual
Prefix:DR
First Name:TINGTING
Middle Name:ZHU
Last Name:FREED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3613 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-3238
Mailing Address - Country:US
Mailing Address - Phone:703-893-6680
Mailing Address - Fax:
Practice Address - Street 1:3613 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-3238
Practice Address - Country:US
Practice Address - Phone:703-893-6680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014121711223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice