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General NPI Number Information
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NPI Number | 1417874512
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Entity Type | Individual
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Provider Name | DR. ZARA PETROSYAN
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Gender | Female
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 1760 SOLANO AVE STE 309
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City | BERKELEY
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State | CA
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Zip | 94707-2218
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Country | US
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Telephone | 510-527-9564
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Fax |
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Provider Business Mailing Address
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Address Line | 199 NEW MONTGOMERY ST UNIT 607
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City | SAN FRANCISCO
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State | CA
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Zip | 94105-3804
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 113259
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 113259
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License Number State | CA
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