Provider Demographics
NPI:1356418065
Name:ZIADEH, FAHER C (DDS)
Entity type:Individual
Prefix:DR
First Name:FAHER
Middle Name:C
Last Name:ZIADEH
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 1:2003 SHELLBACK PL
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1144
Mailing Address - Country:US
Mailing Address - Phone:408-259-4438
Mailing Address - Fax:
Practice Address - Street 1:2998 EL CAMINO REAL
Practice Address - Street 2:#200
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-2938
Practice Address - Country:US
Practice Address - Phone:408-241-2397
Practice Address - Fax:408-246-4243
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist