Provider Demographics
NPI:1497884985
Name:PAYAM ZAREI DDS-BERKELEY DENTAL CARE PC
Entity Type:Organization
Organization Name:PAYAM ZAREI DDS-BERKELEY DENTAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAYAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAREI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-449-8683
Mailing Address - Street 1:1752 N TAFT AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:IL
Mailing Address - Zip Code:60163-1555
Mailing Address - Country:US
Mailing Address - Phone:708-449-8683
Mailing Address - Fax:708-449-8806
Practice Address - Street 1:1752 N TAFT AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:IL
Practice Address - Zip Code:60163-1555
Practice Address - Country:US
Practice Address - Phone:708-449-8683
Practice Address - Fax:708-449-8806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty