Healthcare Provider Details

I. General information

NPI: 1467685834
Provider Name (Legal Business Name): TANYA ZAGHI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2009
Last Update Date: 09/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 OAK GROVE AVE STE 6
MENLO PARK CA
94025-4428
US

IV. Provider business mailing address

888 OAK GROVE AVE STE 6
MENLO PARK CA
94025-4428
US

V. Phone/Fax

Practice location:
  • Phone: 650-327-8081
  • Fax: 650-327-8082
Mailing address:
  • Phone: 650-327-8081
  • Fax: 650-327-8082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number54045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: