Individual provider Active NPI

Takish Ziad

  • Pediatric Dentistry
  • Casa Grande, AZ
National Provider Identifier
1063769818
Registry record updated Oct 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D010986 Issued in AZ
Practice address
865 N Arizola Rd
Casa Grande, AZ 85122-6011
Phone
(520) 381-0381
NPI assigned
Aug 11, 2012
Last updated
Oct 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401412713 VA
Pediatric Dentistry 1223P0221X 60294023 WA
Pediatric Dentistry 1223P0221X D010986 AZ Primary

Addresses

Primary practice location

865 N Arizola Rd
Casa Grande, AZ 85122-6011

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Other practice location 1

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3200

Other practice location 2

1864 E Florence Blvd Ste 1
Casa Grande, AZ 85122-5504
Phone (520) 350-7560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401412713VAMDDentist
D010986AZMDPediatric Dentist
60294023WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. PastSince Feb 1, 2022 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1063769818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 N ARIZOLA RD",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851226011",
            "telephone_number": "520-381-0381"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Kern Way",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989026340",
            "country_code": "US",
            "telephone_number": "509-574-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1864 E Florence Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Casa Grande",
            "state": "AZ",
            "postal_code": "851225504",
            "country_code": "US",
            "telephone_number": "520-350-7560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIAD",
        "first_name": "TAKISH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-11",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412713",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "60294023",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "AZ",
            "license": "D010986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.