=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871456228
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | P.M. ZAKHARY DDS, BPDC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/03/2025
-----------------------------------------------------
Last Update Date | 12/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8402 COMMONWEALTH AVE
-----------------------------------------------------
City | BUENA PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90621-2528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-739-2051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8402 COMMONWEALTH AVE
-----------------------------------------------------
City | BUENA PARK
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90621-2528
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 714-739-2051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PETER MAGED ZAKHARY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 714-739-2051
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------