MEDICARE: NAZANIN ALAMEH ZADEH DDS

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	1223G0001X	General Practice Dentistry	49724	CA

General Provider Information

NPI Number	:	1124196647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAZANIN ALAMEH ZADEH DDS

Provider Business Mailing Address
First Line	:	24060 CAMINO DEL AVION STE 4B
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-4006
Country	:	US
Telephone Number	:	858-349-9770
Fax Number	:

Provider Business Practice Location Address
First Line	:	24060 CAMINO DEL AVION STE 4B
Second Line	:
City	:	DANA POINT
State	:	CA
Zip	:	92629-4006
Country	:	US
Telephone Number	:	858-349-9770
Fax Number	:

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

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	01/04/2011

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