Provider Demographics
NPI:1043651839
Name:MUHAMMAD, SULTAN IJAZ (DMD)
Entity type:Individual
Prefix:DR
First Name:SULTAN
Middle Name:IJAZ
Last Name:MUHAMMAD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2823 HUNTER RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-1437
Mailing Address - Country:US
Mailing Address - Phone:978-996-8147
Mailing Address - Fax:
Practice Address - Street 1:21680 RIDGETOP CIR STE 120
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-4292
Practice Address - Country:US
Practice Address - Phone:703-444-5095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-10
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program