Healthcare Provider Details

I. General information

NPI: 1679487854
Provider Name (Legal Business Name): ANAHEIM DENTAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3174 W LINCOLN AVE STE 102
ANAHEIM CA
92801-6085
US

IV. Provider business mailing address

3174 W LINCOLN AVE STE 102
ANAHEIM CA
92801-6085
US

V. Phone/Fax

Practice location:
  • Phone: 714-826-5000
  • Fax: 714-826-5020
Mailing address:
  • Phone: 714-826-5000
  • Fax: 714-826-5020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. PETER M ZAKHARY
Title or Position: CEO
Credential: DDS
Phone: 714-404-5000