1306513023 NPI number — ZOYA'S OROFACIAL PAIN AND DENTAL SLEEP REMEDIES PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306513023 NPI number — ZOYA'S OROFACIAL PAIN AND DENTAL SLEEP REMEDIES PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZOYA'S OROFACIAL PAIN AND DENTAL SLEEP REMEDIES PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306513023
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
18500 COUNTY ROAD 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55447-2531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-735-0950
Provider Business Mailing Address Fax Number:
952-920-9749

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1405 LILAC LANE DRIVE NORTH
Provider Second Line Business Practice Location Address:
SUITE 150 K
Provider Business Practice Location Address City Name:
GOLDEN VALLEY
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55422-4536
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-762-6549
Provider Business Practice Location Address Fax Number:
763-762-6573
Provider Enumeration Date:
08/30/2021

Additional Information

Authorized Official

Authorized Official Last Name:
SIDDIQUI
Authorized Official First Name:
MARIAM
Authorized Official Middle Name:
TAHIR
Authorized Official Title or Position:
DR
Authorized Official Telephone Number:
612-735-0950

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223X2210X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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