Healthcare Provider Details

I. General information

NPI: 1407767643
Provider Name (Legal Business Name): KAZIM DENTAL GROUP P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 WASHINGTON AVE
BELLEVILLE NJ
07109-2926
US

IV. Provider business mailing address

136 WASHINGTON AVE
BELLEVILLE NJ
07109-2926
US

V. Phone/Fax

Practice location:
  • Phone: 484-888-3925
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ZESHAWN KAZIM
Title or Position: PRESIDENT
Credential:
Phone: 484-888-3925