Healthcare Provider Details

I. General information

NPI: 1881529196
Provider Name (Legal Business Name): DR. ZAINAB QAZALBASH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 E 2100 S STE 3
SALT LAKE CITY UT
84106-2680
US

IV. Provider business mailing address

396 E 10425 S
SANDY UT
84070-0917
US

V. Phone/Fax

Practice location:
  • Phone: 801-438-6355
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14290747-9926
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: