Provider Demographics
NPI:1730386871
Name:ALI, ZIAD A (MD, DMD)
Entity type:Individual
Prefix:DR
First Name:ZIAD
Middle Name:A
Last Name:ALI
Suffix:
Gender:M
Credentials:MD, DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6812 WEMBERLY WAY
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-1531
Mailing Address - Country:US
Mailing Address - Phone:240-274-7257
Mailing Address - Fax:
Practice Address - Street 1:6845 ELM ST STE 225
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22101-3865
Practice Address - Country:US
Practice Address - Phone:703-356-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012481211223S0112X
VA04014124501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery