NPIMap

Organization Active NPI

Az Dental PLLC

  • General Practice Dentistry
  • Putnam, CT
National Provider Identifier
1720760598
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AZ DENTAL PLLC
Practice address
64 Grove St
Putnam, CT 06260-2110
Phone
(860) 928-4352
NPI assigned
Aug 2, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Yazan Abou Zakhem, DMDNPI 1841807104
Title
Dentist
Phone
(201) 640-1046

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

64 Grove St
Putnam, CT 06260-2110

Mailing address

64 Grove St
Putnam, CT 06260-2110
Phone (860) 928-4352

National Provider Directory

National Provider Directory
Tax ID family
Az Dental PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

64 Grove St
Putnam, CT 06260
Phone (860) 928-4352

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1720760598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 GROVE ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062602110",
            "telephone_number": "860-928-4352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 GROVE ST",
            "city": "PUTNAM",
            "state": "CT",
            "postal_code": "062602110",
            "telephone_number": "860-928-4352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZ DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "ABOU ZAKHEM",
        "authorized_official_first_name": "YAZAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-640-1046",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Putnam, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; 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.