Provider Demographics
NPI:1184409328
Name:AL-AZZAWI, ZAINAB (DMD)
Entity type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:AL-AZZAWI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E WYNNEWOOD RD APT 18D
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-1518
Mailing Address - Country:US
Mailing Address - Phone:989-572-9467
Mailing Address - Fax:
Practice Address - Street 1:9027 W CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-1107
Practice Address - Country:US
Practice Address - Phone:610-352-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS044275122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist