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General NPI Number Information
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NPI Number | 1356275879
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Entity Type | Organization
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Legal Business Name | ZAKHAR ORTHODONTICS LLC
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 149 RIVERWALK BLVD STE 6
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City | RIDGELAND
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State | SC
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Zip | 29936-8191
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Country | US
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Telephone | 854-213-5566
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Fax |
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Provider Business Mailing Address
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Address Line | 149 RIVERWALK BLVD STE 6
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City | RIDGELAND
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State | SC
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Zip | 29936-8191
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Country | US
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Telephone | 854-213-5566
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GRANT ZAKHAR
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Credential | DDS, MSD
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Telephone | 708-259-7663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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