Provider Demographics
NPI:1053173369
Name:MANAL KAZI DMD, LLC
Entity type:Organization
Organization Name:MANAL KAZI DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MANAL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAZI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-960-9170
Mailing Address - Street 1:65 E NORTHFIELD RD STE C
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4525
Mailing Address - Country:US
Mailing Address - Phone:973-500-4440
Mailing Address - Fax:
Practice Address - Street 1:65 E NORTHFIELD RD STE C
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4525
Practice Address - Country:US
Practice Address - Phone:973-500-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty