Provider Demographics
NPI:1871829234
Name:ZIADEH, SENAN KHALIL (BDS;DDS;MSCD;DSCD;)
Entity Type:Individual
Prefix:DR
First Name:SENAN
Middle Name:KHALIL
Last Name:ZIADEH
Suffix:
Gender:M
Credentials:BDS;DDS;MSCD;DSCD;
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4131 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3004
Mailing Address - Country:US
Mailing Address - Phone:617-840-5962
Mailing Address - Fax:
Practice Address - Street 1:4131 N 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-3004
Practice Address - Country:US
Practice Address - Phone:617-840-5962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-20
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE602471291223X0400X
LA69221223X0400X
VA04014133831223X0400X
CA497151223X0400X
TX346051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics