Provider Demographics
NPI:1659548881
Name:EDWIN ZAGHI DMD PC
Entity Type:Organization
Organization Name:EDWIN ZAGHI DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAGHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:410-992-4400
Mailing Address - Street 1:10910 LITTLE PATUXENT PKWY STE 103R
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3081
Mailing Address - Country:US
Mailing Address - Phone:917-846-7655
Mailing Address - Fax:
Practice Address - Street 1:10910 LITTLE PATUXENT PKWY STE 103R
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3081
Practice Address - Country:US
Practice Address - Phone:917-846-7655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD134441223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty