=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285704767
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AREZO ZARGHOUNI DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/09/2006
-----------------------------------------------------
Last Update Date | 02/08/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14119 STUEBNER AIRLINE RD PRESTIGIOUS SMILES LLC
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77069-3525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-880-6666
-----------------------------------------------------
Fax | 832-446-3472
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14119 STUEBNER AIRLINE RD PRESTIGIOUS SMILES LLC
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77069-3525
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 281-880-6666
-----------------------------------------------------
Fax | 832-446-3472
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 20963
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------