Healthcare Provider Details

I. General information

NPI: 1639939176
Provider Name (Legal Business Name): NORA ZAKHARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 12/13/2025
Certification Date: 12/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

678 W ARROW HWY
SAN DIMAS CA
91773-2958
US

IV. Provider business mailing address

525 S SANTA FE AVE APT 2714
LOS ANGELES CA
90013-2920
US

V. Phone/Fax

Practice location:
  • Phone: 909-618-1307
  • Fax:
Mailing address:
  • Phone: 440-339-5713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDDS112164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: