Provider Demographics
NPI:1942649454
Name:AL ANBAKI, ZAID (DMD)
Entity type:Individual
Prefix:
First Name:ZAID
Middle Name:
Last Name:AL ANBAKI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:162 KENDRICK PL
Mailing Address - Street 2:APT 14
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-5657
Mailing Address - Country:US
Mailing Address - Phone:734-657-5038
Mailing Address - Fax:
Practice Address - Street 1:1730 MASSEY BLVD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6973
Practice Address - Country:US
Practice Address - Phone:717-497-1097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS039584122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist