Healthcare Provider Details

I. General information

NPI: 1568504132
Provider Name (Legal Business Name): NEHAL ZAVERI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 09/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 ALTA AVE 205
UPLAND CA
91786-2800
US

IV. Provider business mailing address

1113 ALTA AVE 205
UPLAND CA
91786-2800
US

V. Phone/Fax

Practice location:
  • Phone: 909-985-6116
  • Fax: 909-985-6226
Mailing address:
  • Phone: 909-786-5331
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number53305
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: