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

Table of content: (NPI 1306513023)

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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