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NPI 1336838374

NPI 1336838374 : SYED HASSAN ABBAS ZAIDI : SURPRISE, AZ

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General NPI Number Information
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    NPI Number           |    1336838374
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    Entity Type          |    Individual 
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    Provider Name        |    SYED HASSAN ABBAS ZAIDI
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    05/04/2023
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    Last Update Date     |    03/27/2025
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Provider Practice Location Address
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    Address Line         |    17200 W PEORIA AVE STE 116 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85388-0006
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    Country              |    US
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    Telephone            |    623-738-0312
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    17200 W PEORIA AVE STE 116 
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    City                 |    SURPRISE
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    State                |    AZ
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    Zip                  |    85388-0006
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    Country              |    US
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    Telephone            |    623-738-0312
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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       |    019.034562
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    License Number State |    IL
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Taxonomy #2
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    D012401
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    License Number State |    AZ
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