Healthcare Provider Details

I. General information

NPI: 1073047775
Provider Name (Legal Business Name): ZAVERI DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 E FOOTHILL BLVD
UPLAND CA
91786-3952
US

IV. Provider business mailing address

311 E FOOTHILL BLVD
UPLAND CA
91786-3952
US

V. Phone/Fax

Practice location:
  • Phone: 909-985-6116
  • Fax: 909-985-6226
Mailing address:
  • Phone: 909-985-6116
  • Fax: 909-985-6226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number53305
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number43182
License Number StateCA

VIII. Authorized Official

Name: DR. NEHAL ZAVERI
Title or Position: DENTIST/OWNER
Credential: D.D.S.
Phone: 909-985-6116