Provider Demographics
NPI:1174544159
Name:AZIZ, KALID (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:KALID
Middle Name:
Last Name:AZIZ
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2155 WEBSTER ST # C12
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2333
Mailing Address - Country:US
Mailing Address - Phone:415-749-3329
Mailing Address - Fax:
Practice Address - Street 1:2155 WEBSTER ST
Practice Address - Street 2:FACULTY PRACTICE
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-2333
Practice Address - Country:US
Practice Address - Phone:414-929-6524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2013-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI37-8751223G0001X
CA59399122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice