Provider Demographics
NPI:1245796283
Name:JIHANE M RIAD, DDS, PLLC
Entity type:Organization
Organization Name:JIHANE M RIAD, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-434-0610
Mailing Address - Street 1:5875 SNYDER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094
Mailing Address - Country:US
Mailing Address - Phone:716-434-0610
Mailing Address - Fax:716-434-4394
Practice Address - Street 1:5875 SNYDER DRIVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094
Practice Address - Country:US
Practice Address - Phone:716-434-0610
Practice Address - Fax:716-434-4394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-14
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1457378549OtherGENERAL DENTISTRY
NY1063432102OtherGENERAL DENTISTRY
NY1235678640OtherGENERAL DENTISTRY
NY1548287626OtherGENERAL DENTISTRY