Zaki M Mukdissi DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19475 Issued in MA

Legal business name

ZAKI M MUKDISSI DMD PC

Practice address

616 Fellsway
Second Floor
Medford, MA 02155

Phone

(781) 306-9644

Fax

(781) 306-9726

NPI assigned

Sep 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Zaki M Mukdissi, DMD

Title

President

Phone

(781) 306-9644

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720180151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 FELLSWAY",
            "address_2": "SECOND FLOOR",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-306-9644",
            "fax_number": "781-306-9726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 FELLSWAY",
            "address_2": "SECOND FLOOR",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "02155",
            "telephone_number": "781-306-9644",
            "fax_number": "781-306-9726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZAKI M MUKDISSI DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MUKDISSI",
        "authorized_official_first_name": "ZAKI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-306-9644",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19475",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "0201456",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Young
• Laurie Young
• Teresa Mary Zabik, M.D.
• Michael Baruch Zack, MD
• Nabil Suhil Zahka, DMD
• Silvana Maria Zambrano Almenara
• Jason Zanes, MHC
• Zenith Pain & Neurological Care PLLC
• Stephanie Zera
• Qingqing Zhang Lam

• General Practice Dentistry in Medford, MA
• Providers in Medford, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.