Provider Demographics
NPI:1548837446
Name:QARYAQOS, ZAID (DMD)
Entity type:Individual
Prefix:
First Name:ZAID
Middle Name:
Last Name:QARYAQOS
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 1:17299 SE ELIAS CT
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:OR
Mailing Address - Zip Code:97089-5661
Mailing Address - Country:US
Mailing Address - Phone:503-839-0048
Mailing Address - Fax:
Practice Address - Street 1:25700 SW ARGYLE AVE STE F
Practice Address - Street 2:
Practice Address - City:WILSONVILLE
Practice Address - State:OR
Practice Address - Zip Code:97070-5799
Practice Address - Country:US
Practice Address - Phone:503-682-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11440122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist