Provider Demographics
NPI:1194971093
Name:ESKANDAR, ZIAD
Entity type:Individual
Prefix:
First Name:ZIAD
Middle Name:
Last Name:ESKANDAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E SPRINGFIELD ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-3354
Mailing Address - Country:US
Mailing Address - Phone:832-755-2337
Mailing Address - Fax:
Practice Address - Street 1:700 ESSEX ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01841-4396
Practice Address - Country:US
Practice Address - Phone:630-222-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA222961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice