Provider Demographics
NPI:1003471517
Name:ZORA, JONATHAN SAHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:SAHER
Last Name:ZORA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6318 ORCHARD WOODS DR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-3287
Mailing Address - Country:US
Mailing Address - Phone:248-207-6972
Mailing Address - Fax:
Practice Address - Street 1:22801 NEWMAN ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2200
Practice Address - Country:US
Practice Address - Phone:313-274-8522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2022-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI2901600541122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program