Healthcare Provider Details

I. General information

NPI: 1073404257
Provider Name (Legal Business Name): DINA ZOMA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37732 HOLLYHEAD DR
FARMINGTON HILLS MI
48331-1717
US

IV. Provider business mailing address

37732 HOLLYHEAD DR
FARMINGTON HILLS MI
48331-1717
US

V. Phone/Fax

Practice location:
  • Phone: 248-469-6107
  • Fax:
Mailing address:
  • Phone: 248-469-6107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: