Provider Demographics
NPI:1093331522
Name:ZAHM, STEPHEN ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:ALAN
Last Name:ZAHM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9101 N 250 E
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:IN
Mailing Address - Zip Code:46783-9124
Mailing Address - Country:US
Mailing Address - Phone:260-388-9999
Mailing Address - Fax:
Practice Address - Street 1:22 VINE ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-1409
Practice Address - Country:US
Practice Address - Phone:260-356-9550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013404A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist