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General NPI Number Information
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NPI Number | 1669272415
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Entity Type | Individual
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Provider Name | JEFFREY SHAWN ZHAO DDS
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Gender | Male
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 303 S GLENOAKS BLVD STE 12
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City | BURBANK
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State | CA
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Zip | 91502-1184
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Country | US
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Telephone | 818-846-2854
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Fax |
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Provider Business Mailing Address
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Address Line | 1833 PAMPAS CIR
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City | BOLINGBROOK
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State | IL
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Zip | 60490-2070
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Country | US
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Telephone | 312-810-6965
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 110618
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 110618
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License Number State | CA
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