Provider Demographics
NPI:1871623082
Name:RAZA, SAFIYA (DMD)
Entity type:Individual
Prefix:DR
First Name:SAFIYA
Middle Name:
Last Name:RAZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:SAFIYA
Other - Middle Name:
Other - Last Name:RAZA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:35865 SPATTERDOCK LN
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6503
Mailing Address - Country:US
Mailing Address - Phone:440-528-8504
Mailing Address - Fax:
Practice Address - Street 1:1530 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2004
Practice Address - Country:US
Practice Address - Phone:216-781-6724
Practice Address - Fax:216-781-6723
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21994122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist