I Zak DDS Prof Dental Corp
Dentist in Long Beach, CA. Organization (NPI-2).
NPI number1033859863
StatusActive
Last updated in NPPESMar 30, 2022
Details
- NPI
- 1033859863
- Entity type
- Organization (NPI-2)
- Legal business name
- I Zak DDS Prof Dental Corp
- Organization subpart
- No
- Enumeration date
- Mar 30, 2022
- Certification date
- Mar 30, 2022
- Last updated
- Mar 30, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
| 1223E0200X | Dentist, Endodontics | – | – | |
| 1223G0001X | Dentist, General Practice | – | – | |
| 1223P0300X | Dentist, Periodontics | – | – | |
| 1223S0112X | Dentist, Oral and Maxillofacial Surgery | – | – | |
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – |
Other names
- Dr. Zak Long Beach Dental Care (Other Name)
Practice location
3620 Long Beach Blvd Ste B6Long Beach, CA 90807-6008
Phone 562-426-6458
Mailing address
10501 Lakewood BlvdDowney, CA 90241-2709
Authorized official
Ilya Zak
President/Ceo
3108055201
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