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General NPI Number Information
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NPI Number | 1023940848
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Entity Type | Individual
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Provider Name | FARIS MUJAHED ZIYAD DMD
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Gender | Male
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 7934 N LINDBERGH BLVD
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City | HAZELWOOD
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State | MO
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Zip | 63042-3521
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Country | US
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Telephone | 314-818-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 4041 CHOUTEAU AVE APT 242
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1740
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Country | US
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Telephone | 708-980-9365
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2026022578
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License Number State | MO
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