MEDICARE: SANDERSON AND ZARGARIAN DENTAL CORP.

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	48480	CA
2	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	48480	OTHER	CA	CALIFORNIA DENTAL BOARD
2	1063541985	OTHER	CA	NATIONAL PROVIDER NUMBER
3	50845	OTHER	CA	CALIFORNIA DENTAL BOARD

General Provider Information

NPI Number	:	1306181474
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANDERSON AND ZARGARIAN DENTAL CORP.

Provider Business Mailing Address
First Line	:	2014 W. AVE K
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5229
Country	:	US
Telephone Number	:	661-729-2990
Fax Number	:	661-206-6810

Provider Business Practice Location Address
First Line	:	2014 W. AVE K
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93536-5229
Country	:	US
Telephone Number	:	661-729-2990
Fax Number	:	661-206-6810

Authorized Official
Title or Position	:	CEO, PRESIDENT
Name	:	ALBERT ZARGARIAN
Credential	:	DMD
Telephone Number	:	661-350-3346

Provider Enumeration Date	:	11/30/2012
Last Update Date	:	06/27/2022

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