Healthcare Provider Details

I. General information

NPI: 1871127209
Provider Name (Legal Business Name): PARISA ZARE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2020
Last Update Date: 10/20/2020
Certification Date: 10/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 WATERSIDE PLZ APT 23E
NEW YORK NY
10010-2633
US

IV. Provider business mailing address

40 WATERSIDE PLZ APT 23E
NEW YORK NY
10010-2633
US

V. Phone/Fax

Practice location:
  • Phone: 646-281-6153
  • Fax:
Mailing address:
  • Phone: 646-281-6153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number36234
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7117
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number0401416859
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: