MEDICARE: LEILA ZAMIRI DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist
2	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1093347437
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEILA ZAMIRI DDS INC

Provider Business Mailing Address
First Line	:	3317 E 10TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-5050
Country	:	US
Telephone Number	:	562-438-2500
Fax Number	:	562-438-2555

Provider Business Practice Location Address
First Line	:	3317 E 10TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90804-5050
Country	:	US
Telephone Number	:	562-438-2500
Fax Number	:	562-438-2555

Authorized Official
Title or Position	:	CEO
Name	:	LEILA ZAMIRI
Credential	:
Telephone Number	:	562-422-6838

Provider Enumeration Date	:	02/04/2020
Last Update Date	:	02/04/2020

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