Provider Demographics
NPI:1457495699
Name:ZIAH, JAMES ROBERT (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ROBERT
Last Name:ZIAH
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 1:1425 MCHENRY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BUFFALO GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60089-1365
Mailing Address - Country:US
Mailing Address - Phone:847-955-1500
Mailing Address - Fax:
Practice Address - Street 1:1425 MCHENRY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1365
Practice Address - Country:US
Practice Address - Phone:847-955-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist