Provider Demographics
NPI:1063085447
Name:ZAYYAD, BANA ADEL (DDS)
Entity type:Individual
Prefix:DR
First Name:BANA
Middle Name:ADEL
Last Name:ZAYYAD
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 1:9200 S 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-1910
Mailing Address - Country:US
Mailing Address - Phone:708-600-5905
Mailing Address - Fax:
Practice Address - Street 1:8729 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEVIEW
Practice Address - State:IL
Practice Address - Zip Code:60455-1905
Practice Address - Country:US
Practice Address - Phone:708-599-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0333471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice