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NPI Code Detail

MEDICARE: ZAID DENTISTRY INC.

MEDICARE: ZAID DENTISTRY INC.
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
1122300000XDentist019029496IL

General Provider Information

NPI Number : 1285061572
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZAID DENTISTRY INC.
Provider Business Mailing Address
First Line : 2416 W THOMAS ST
Second Line : APT. 3
City : CHICAGO
State : IL
Zip : 60622-3531
Country : US
Telephone Number : 804-307-1012
Fax Number :
Provider Business Practice Location Address
First Line : 2416 W THOMAS ST
Second Line : APT. 3
City : CHICAGO
State : IL
Zip : 60622-3531
Country : US
Telephone Number : 804-307-1012
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. ZAID JERRIE AL-SAMIR
Credential : DDS
Telephone Number : 804-307-1012
Provider Enumeration Date : 10/01/2013
Last Update Date : 10/01/2013

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Directions to “ZAID DENTISTRY INC. ” Practice Location

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