Healthcare Provider Details

I. General information

NPI: 1316017957
Provider Name (Legal Business Name): PARVIN ZEKAVAT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38745 N TIERRA SUBIDA #150 SMILE CARE FAMILY DENTAL GROUP
PALMDALE CA
93551
US

IV. Provider business mailing address

25870 WEBSTER PLACE
STEVENSON RANCH CA
91381
US

V. Phone/Fax

Practice location:
  • Phone: 661-272-9091
  • Fax:
Mailing address:
  • Phone: 661-254-0544
  • Fax: 661-254-0544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberU6352
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: