MEDICARE: ZEKI ABDULAALI, DDS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1811611940
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEKI ABDULAALI, DDS, INC

Provider Business Mailing Address
First Line	:	2133 KINGS VIEW CIR
Second Line	:
City	:	SPRING VALLEY
State	:	CA
Zip	:	91977-3352
Country	:	US
Telephone Number	:	619-517-0621
Fax Number	:

Provider Business Practice Location Address
First Line	:	10645 TIERRASANTA BLVD STE B
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92124-2614
Country	:	US
Telephone Number	:	858-215-1042
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	STEPHANIE BISCHEL
Credential	:
Telephone Number	:	619-517-0621

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	10/03/2022

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