Healthcare Provider Details

I. General information

NPI: 1669549531
Provider Name (Legal Business Name): REGINA ZAJIA DDS,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/26/2021
Certification Date: 11/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 S HURON PKWY
ANN ARBOR MI
48104-5151
US

IV. Provider business mailing address

2220 S HURON PKWY
ANN ARBOR MI
48104-5151
US

V. Phone/Fax

Practice location:
  • Phone: 734-761-2629
  • Fax:
Mailing address:
  • Phone: 734-761-2629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number17124
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901017124
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: