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General NPI Number Information
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NPI Number | 1992360705
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Entity Type | Individual
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Provider Name | ALEXANDER BORISOVICH ZAYKOV DDS
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Gender | Male
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Dates
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Enumeration Date | 05/07/2019
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 14425 W MCDOWELL RD STE F106
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City | GOODYEAR
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State | AZ
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Zip | 85395-2516
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Country | US
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Telephone | 623-925-8208
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Fax |
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Provider Business Mailing Address
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Address Line | 12218 W MIAMI ST
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City | TOLLESON
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State | AZ
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Zip | 85353-2743
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Country | US
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Telephone | 951-282-6772
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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 | 103901
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | D011424
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License Number State | AZ
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