Healthcare Provider Details

I. General information

NPI: 1942099601
Provider Name (Legal Business Name): GOLNOUSH ZAKERI DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 5TH ST
SAN FRANCISCO CA
94103-2919
US

IV. Provider business mailing address

1714 STONEWICK DR
ALLEN TX
75002-6484
US

V. Phone/Fax

Practice location:
  • Phone: 415-929-6501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number111467
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: