Healthcare Provider Details

I. General information

NPI: 1598839920
Provider Name (Legal Business Name): SUSAN C ZAND DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26730 TOWNE CENTRE DR STE 104
FOOTHILL RANCH CA
92610-2842
US

IV. Provider business mailing address

26730 TOWNE CENTRE DR STE 104
FOOTHILL RANCH CA
92610-2842
US

V. Phone/Fax

Practice location:
  • Phone: 949-273-8900
  • Fax: 949-273-8906
Mailing address:
  • Phone: 949-273-8900
  • Fax: 949-273-8906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number38309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: