MEDICARE: YASMINE ZAENI DDS INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223D0004X	Dental Anesthesiology
2	1223P0221X	Pediatric Dentistry
3	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
4	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1861958654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YASMINE ZAENI DDS INC

Provider Business Mailing Address
First Line	:	5167 CLAYTON RD STE D
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-3163
Country	:	US
Telephone Number	:	925-254-4777
Fax Number	:

Provider Business Practice Location Address
First Line	:	5167 CLAYTON RD STE D
Second Line	:
City	:	CONCORD
State	:	CA
Zip	:	94521-3163
Country	:	US
Telephone Number	:	925-917-9393
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. YASMINE ZAENI
Credential	:	DDS
Telephone Number	:	925-917-9393

Provider Enumeration Date	:	02/16/2019
Last Update Date	:	04/22/2019

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