MEDICARE: DR. JERRY FRANKLIN ZIMRING D.D.S.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	15918	CA

General Provider Information

NPI Number	:	1093720781
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JERRY FRANKLIN ZIMRING D.D.S.

Provider Business Mailing Address
First Line	:	8500 WILSHIRE BLVD
Second Line	:	SUITE 818
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3121
Country	:	US
Telephone Number	:	310-358-5593
Fax Number	:	310-652-5703

Provider Business Practice Location Address
First Line	:	8500 WILSHIRE BLVD
Second Line	:	SUITE 818
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-3121
Country	:	US
Telephone Number	:	310-358-5593
Fax Number	:	310-652-5703

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2006
Last Update Date	:	07/08/2007

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