1407985260 NPI number — ZAINAB ALI-RUBAIE DDS

Table of content: ZAINAB ALI-RUBAIE DDS (NPI 1407985260)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407985260 NPI number — ZAINAB ALI-RUBAIE DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALI-RUBAIE
Provider First Name:
ZAINAB
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DDS
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:
1407985260
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
471 VALLEY RD NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30305-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
626-390-5669
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4203 GAGE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELL
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90201-1212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
323-312-0500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007

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:  46730 , 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)

  • Identifier: 201242170 . This is a "CORPORATION TAX ID" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: G9312001 . This is a "DENTICAL GROUP NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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