Provider Demographics
NPI:1003971771
Name:ZIN, THANT (DDS)
Entity Type:Individual
Prefix:
First Name:THANT
Middle Name:
Last Name:ZIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:THANT
Other - Middle Name:
Other - Last Name:ZIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1845 HAMNER AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:NORCO
Mailing Address - State:CA
Mailing Address - Zip Code:92860-2968
Mailing Address - Country:US
Mailing Address - Phone:951-734-7500
Mailing Address - Fax:951-734-6562
Practice Address - Street 1:1845 HAMNER AVE
Practice Address - Street 2:SUITE D
Practice Address - City:NORCO
Practice Address - State:CA
Practice Address - Zip Code:92860-2968
Practice Address - Country:US
Practice Address - Phone:951-734-7500
Practice Address - Fax:951-734-6562
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA484181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG93210-01OtherDENTICAL