1326243486 NPI number — DR. ZAM TARA NAKHJIRI DDS DENTIST

Table of content: DR. ZAM TARA NAKHJIRI DDS DENTIST (NPI 1326243486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326243486 NPI number — DR. ZAM TARA NAKHJIRI DDS DENTIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAKHJIRI
Provider First Name:
ZAM
Provider Middle Name:
TARA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS DENTIST
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326243486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
436 N ROXBURY DR
Provider Second Line Business Mailing Address:
# NPH
Provider Business Mailing Address City Name:
BEVERLY HILLS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90210
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-271-0461
Provider Business Mailing Address Fax Number:
310-271-1821

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
436 N ROXBURY DR
Provider Second Line Business Practice Location Address:
# NPH
Provider Business Practice Location Address City Name:
BEVERLY HILLS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-271-0461
Provider Business Practice Location Address Fax Number:
310-271-1821
Provider Enumeration Date:
06/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  49943 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com