MEDICARE: ANDREW J. ZAKARIAN, 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	305S00000X	Point of Service	39738	CA

General Provider Information

NPI Number	:	1245428531
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANDREW J. ZAKARIAN, DDS, INC.

Provider Business Mailing Address
First Line	:	3501 4TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-4912
Country	:	US
Telephone Number	:	619-296-6899
Fax Number	:	619-297-5851

Provider Business Practice Location Address
First Line	:	3501 4TH AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-4912
Country	:	US
Telephone Number	:	619-296-6899
Fax Number	:	619-297-5851

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	DR. ANDREW JOHN ZAKARIAN
Credential	:	D.D.S
Telephone Number	:	619-296-6899

Provider Enumeration Date	:	10/11/2007
Last Update Date	:	10/11/2007

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