Healthcare Provider Details

I. General information

NPI: 1164258786
Provider Name (Legal Business Name): ZAVERDINOS DENTAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1273 LAS FLORES DR
CARLSBAD CA
92008-1030
US

IV. Provider business mailing address

1273 LAS FLORES DR
CARLSBAD CA
92008-1030
US

V. Phone/Fax

Practice location:
  • Phone: 760-434-2526
  • Fax:
Mailing address:
  • Phone: 760-434-2526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MICAELA ZAVERDINOS
Title or Position: OWNER
Credential: DMD, MPH, MSD
Phone: 760-434-2526