MEDICARE: PAYAM ZAREI DDS-BERKELEY DENTAL CARE PC

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		IL

General Provider Information

NPI Number	:	1497884985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAYAM ZAREI DDS-BERKELEY DENTAL CARE PC

Provider Business Mailing Address
First Line	:	1752 N TAFT AVE
Second Line	:
City	:	BERKELEY
State	:	IL
Zip	:	60163-1555
Country	:	US
Telephone Number	:	708-449-8683
Fax Number	:	708-449-8806

Provider Business Practice Location Address
First Line	:	1752 N TAFT AVE
Second Line	:
City	:	BERKELEY
State	:	IL
Zip	:	60163-1555
Country	:	US
Telephone Number	:	708-449-8683
Fax Number	:	708-449-8806

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAYAM ZAREI
Credential	:	DDS
Telephone Number	:	708-449-8683

Provider Enumeration Date	:	03/02/2007
Last Update Date	:	08/22/2020

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