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General NPI Number Information
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NPI Number | 1245691351
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Entity Type | Individual
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Provider Name | ZIYAD EFFENDI
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Gender | Male
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 55 GREENE AVE STE LLA
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City | BROOKLYN
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State | NY
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Zip | 11238-6432
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Country | US
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Telephone | 718-230-7676
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Fax |
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Provider Business Mailing Address
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Address Line | 10627 HINTON WAY
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City | MANASSAS
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State | VA
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Zip | 20112-5911
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Country | US
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Telephone | 919-727-9363
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 34507
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 061555
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License Number State | NY
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