Healthcare Provider Details

I. General information

NPI: 1447422316
Provider Name (Legal Business Name): LOBNA ZADA D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR
BALTIMORE MD
21207-6665
US

IV. Provider business mailing address

2200 KERNAN DR
BALTIMORE MD
21207-6665
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-6295
  • Fax: 410-448-6883
Mailing address:
  • Phone: 410-448-6295
  • Fax: 410-448-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License NumberLL540
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: