Provider Demographics
NPI:1891146619
Name:EKBATANI, MARZIEH (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARZIEH
Middle Name:
Last Name:EKBATANI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 HICKORY CT
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2494
Mailing Address - Country:US
Mailing Address - Phone:313-722-4970
Mailing Address - Fax:
Practice Address - Street 1:37 HICKORY CT
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2494
Practice Address - Country:US
Practice Address - Phone:313-722-4970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-22
Last Update Date:2016-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021974122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist