MEDICARE: ZIED DENTAL GROUP 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	122300000X	Dentist	63202	CA

General Provider Information

NPI Number	:	1801304845
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZIED DENTAL GROUP INC

Provider Business Mailing Address
First Line	:	1680 NORTH VINE STREET
Second Line	:	SUITE #200
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8844
Country	:	US
Telephone Number	:	323-464-2033
Fax Number	:	323-464-2893

Provider Business Practice Location Address
First Line	:	1680 NORTH VINE STREET
Second Line	:	SUITE #200
City	:	LOS ANGELES
State	:	CA
Zip	:	90028-8844
Country	:	US
Telephone Number	:	323-464-2033
Fax Number	:	323-464-2893

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	MRS. HEBA ZIED
Credential	:	DDS
Telephone Number	:	323-464-2033

Provider Enumeration Date	:	01/11/2018
Last Update Date	:	01/12/2018

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Directions to “ZIED DENTAL GROUP INC ” Practice Location

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