Healthcare Provider Details
I. General information
NPI: 1063586246
Provider Name (Legal Business Name): ROYA ZOJAJI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/20/2006
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10752 N 89TH PL STE 214
SCOTTSDALE AZ
85260-6251
US
IV. Provider business mailing address
10752 N 89TH PL STE 214
SCOTTSDALE AZ
85260-6251
US
V. Phone/Fax
- Phone: 480-614-8222
- Fax: 480-614-8225
- Phone: 480-614-8222
- Fax: 480-614-8225
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223P0300X |
| Taxonomy | Periodontics |
| License Number | 5488 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: