MEDICARE: ZENON J. FARIAN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	18964	OH

General Provider Information

NPI Number	:	1174534663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZENON J. FARIAN D.D.S.

Provider Business Mailing Address
First Line	:	4101 FAR-O-WAY LANE
Second Line	:
City	:	RICHFIELD
State	:	OH
Zip	:	44286
Country	:	US
Telephone Number	:	440-759-3100
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 E WALLINGS RD STE 100
Second Line	:
City	:	BROADVIEW HTS
State	:	OH
Zip	:	44147-1207
Country	:	US
Telephone Number	:	440-526-9100
Fax Number	:	440-526-2505

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	02/09/2016

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