Healthcare Provider Details

I. General information

NPI: 1417722877
Provider Name (Legal Business Name): DAVID ZAGHI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2023
Last Update Date: 11/16/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2016 E ST
BAKERSFIELD CA
93301-4223
US

IV. Provider business mailing address

3873 WINFORD DR
TARZANA CA
91356-5801
US

V. Phone/Fax

Practice location:
  • Phone: 818-635-4000
  • Fax:
Mailing address:
  • Phone: 818-635-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number109131
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: