Provider Demographics
NPI:1194869263
Name:PAZOKIAN, SID (DDS)
Entity type:Individual
Prefix:
First Name:SID
Middle Name:
Last Name:PAZOKIAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SAEED
Other - Middle Name:
Other - Last Name:PAZOKIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:404 TRESA BROOK CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-8768
Mailing Address - Country:US
Mailing Address - Phone:919-760-7123
Mailing Address - Fax:919-372-9205
Practice Address - Street 1:121 S ESTES DR
Practice Address - Street 2:SUIT#206
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2868
Practice Address - Country:US
Practice Address - Phone:919-933-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5905565Medicaid