Healthcare Provider Details

I. General information

NPI: 1467072595
Provider Name (Legal Business Name): ZAHARA AYUB DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2020
Last Update Date: 11/11/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

658 WHITE HORSE PIKE
ABSECON NJ
08201-2302
US

IV. Provider business mailing address

498A GENISTA AVE
GALLOWAY NJ
08205-4447
US

V. Phone/Fax

Practice location:
  • Phone: 609-677-5155
  • Fax:
Mailing address:
  • Phone: 609-576-0705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02854700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: