Individual
AIZA HUMAYUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
374 STOCKHOLM ST, BROOKLYN, NY 11237-4006
(718) 963-7272
Mailing address
5409 TURNBERRY PARK DR, GLEN ALLEN, VA 23059-6023
(510) 396-3695
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DEN2000075
DC
1223G0001X
General Practice Dentistry
Primary
DEN2000075
DC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/27/2020
Last updated
02/09/2022
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