Provider Demographics
NPI:1043439235
Name:ZIMMET, EDWIN J (DMD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:J
Last Name:ZIMMET
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE STE 1350
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6935
Mailing Address - Country:US
Mailing Address - Phone:301-652-1545
Mailing Address - Fax:301-652-4171
Practice Address - Street 1:5454 WISC. AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815
Practice Address - Country:US
Practice Address - Phone:301-652-1545
Practice Address - Fax:301-652-4171
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15310122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist