Provider Demographics
NPI:1346466117
Name:AL-ZOUBAIDY, YASMIN (DMD, ENDODONTIST)
Entity Type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:AL-ZOUBAIDY
Suffix:
Gender:F
Credentials:DMD, ENDODONTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 ERIE DR
Mailing Address - Street 2:
Mailing Address - City:ORCHARD LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1526
Mailing Address - Country:US
Mailing Address - Phone:617-320-5614
Mailing Address - Fax:
Practice Address - Street 1:3752 ERIE DR
Practice Address - Street 2:
Practice Address - City:ORCHARD LAKE
Practice Address - State:MI
Practice Address - Zip Code:48324-1526
Practice Address - Country:US
Practice Address - Phone:617-320-5614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010193091223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics