Provider Demographics
NPI:1952735821
Name:ALLAHEM, ZIYAD (BDS, MS, FRCD(C))
Entity Type:Individual
Prefix:DR
First Name:ZIYAD
Middle Name:
Last Name:ALLAHEM
Suffix:
Gender:M
Credentials:BDS, MS, FRCD(C)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 BROOKLINE AVE
Mailing Address - Street 2:UNIT 828
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3937
Mailing Address - Country:US
Mailing Address - Phone:909-570-7139
Mailing Address - Fax:
Practice Address - Street 1:188 LONGWOOD AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5819
Practice Address - Country:US
Practice Address - Phone:617-432-8304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADL120281223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics