Provider Demographics
NPI:1457378549
Name:RIAD, JIHANE M (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIHANE
Middle Name:M
Last Name:RIAD
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 1:219 HAWLEY ST
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-2717
Mailing Address - Country:US
Mailing Address - Phone:716-434-0610
Mailing Address - Fax:716-434-4394
Practice Address - Street 1:219 HAWLEY ST
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-2717
Practice Address - Country:US
Practice Address - Phone:716-434-0610
Practice Address - Fax:716-434-4394
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0502091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice