Healthcare Provider Details

I. General information

NPI: 1134934672
Provider Name (Legal Business Name): ZHI LI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4017 N PRINCE ST
CLOVIS NM
88101-9705
US

IV. Provider business mailing address

715 W 41S STREET
LOS ANGELES CA
90037
US

V. Phone/Fax

Practice location:
  • Phone: 575-762-2757
  • Fax:
Mailing address:
  • Phone: 402-937-4334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDB-2025-0013
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: