Provider Demographics
NPI:1346875754
Name:FERAS ZIADAT DMD PLLC
Entity Type:Organization
Organization Name:FERAS ZIADAT DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:FERAS
Authorized Official - Middle Name:ZIAD
Authorized Official - Last Name:ZIADAT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:602-481-9876
Mailing Address - Street 1:1720 E WARNER RD STE 5
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-4542
Mailing Address - Country:US
Mailing Address - Phone:480-345-7413
Mailing Address - Fax:
Practice Address - Street 1:1720 E WARNER RD STE 5
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85284-4542
Practice Address - Country:US
Practice Address - Phone:480-345-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental