Provider Demographics
NPI:1417091240
Name:ZADIK, DAVID A (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:ZADIK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:FREDERICK
Other - Middle Name:A
Other - Last Name:STANGE
Other - Suffix:III
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3 WOODSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830
Mailing Address - Country:US
Mailing Address - Phone:203-869-5215
Mailing Address - Fax:
Practice Address - Street 1:210 E 47TH ST
Practice Address - Street 2:SUITE 1D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-2108
Practice Address - Country:US
Practice Address - Phone:212-888-3570
Practice Address - Fax:212-888-0506
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0407701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice