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General NPI Number Information
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NPI Number | 1295585800
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Entity Type | Organization
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Legal Business Name | ZAHRA H. EZZY D.D.S. INC
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Dates
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Enumeration Date | 03/26/2024
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 13422 NEWPORT AVE STE N
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City | TUSTIN
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State | CA
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Zip | 92780-3746
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Country | US
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Telephone | 714-730-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 13422 NEWPORT AVE STE N
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City | TUSTIN
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State | CA
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Zip | 92780-3746
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Country | US
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Telephone | 714-730-5600
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ZAHRA HANIEH EZZY
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Credential | D.D.S
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Telephone | 714-730-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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