Provider Demographics
NPI:1093782781
Name:ZIDE, MICHAEL F (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:F
Last Name:ZIDE
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 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-9109
Mailing Address - Country:US
Mailing Address - Phone:214-648-3034
Mailing Address - Fax:214-648-2918
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-9109
Practice Address - Country:US
Practice Address - Phone:214-648-3034
Practice Address - Fax:214-648-2918
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14271122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1332355Medicaid
TX1332355Medicaid
TX86152NMedicare ID - Type Unspecified