MEDICARE: ZAVERDINOS DENTAL PRACTICE CORP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223G0001X	General Practice Dentistry
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
3	122300000X	Dentist

General Provider Information

NPI Number	:	1548147903
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZAVERDINOS DENTAL PRACTICE CORP

Provider Business Mailing Address
First Line	:	1273 LAS FLORES DR
Second Line	:
City	:	CARLSBAD
State	:	CA
Zip	:	92008-1030
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 W MADISON AVE STE 200
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-3456
Country	:	US
Telephone Number	:	619-440-6364
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICAELA ZAVERDINOS
Credential	:	DMD, MPH, MSD
Telephone Number	:	215-505-0708

Provider Enumeration Date	:	08/18/2025
Last Update Date	:	08/20/2025

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Directions to “ZAVERDINOS DENTAL PRACTICE CORP ” Practice Location

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