Provider Demographics
NPI:1194174144
Name:KAZIM, ADNAN (DMD)
Entity type:Individual
Prefix:DR
First Name:ADNAN
Middle Name:
Last Name:KAZIM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 S LENOLA RD BLDG 3A
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-1561
Mailing Address - Country:US
Mailing Address - Phone:856-778-5533
Mailing Address - Fax:
Practice Address - Street 1:509 S LENOLA RD BLDG 3A
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-1561
Practice Address - Country:US
Practice Address - Phone:856-778-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-10
Last Update Date:2022-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040900122300000X
NJ22DI027039001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist