Provider Demographics
NPI:1972508976
Name:TZENDZALIAN, PETER A (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:A
Last Name:TZENDZALIAN
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:P.O. BOX 51127
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27717-1127
Mailing Address - Country:US
Mailing Address - Phone:919-402-9200
Mailing Address - Fax:919-287-2525
Practice Address - Street 1:3608 SHANNON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707
Practice Address - Country:US
Practice Address - Phone:919-402-9200
Practice Address - Fax:919-287-2525
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2021-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC72361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice