Healthcare Provider Details

I. General information

NPI: 1669550125
Provider Name (Legal Business Name): FARRAH ZAERY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27725 SANTA MARGARITA PKWY STE 270
MISSION VIEJO CA
92691-6708
US

IV. Provider business mailing address

12848 S RENE ST
OLATHE KS
66062
US

V. Phone/Fax

Practice location:
  • Phone: 949-951-0951
  • Fax: 949-652-3445
Mailing address:
  • Phone: 913-768-6191
  • Fax: 913-451-7323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberKS6731
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number53362
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: