Provider Demographics
NPI:1033300058
Name:ZANZI DENTAL GROUP, APC
Entity Type:Organization
Organization Name:ZANZI DENTAL GROUP, APC
Other - Org Name:ADVANCED DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:NADER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZANZI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-780-7676
Mailing Address - Street 1:6910 DOUGLAS BLVD
Mailing Address - Street 2:SUITE F
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746-6276
Mailing Address - Country:US
Mailing Address - Phone:916-780-7676
Mailing Address - Fax:916-780-7681
Practice Address - Street 1:6910 DOUGLAS BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:GRANITE BAY
Practice Address - State:CA
Practice Address - Zip Code:95746-6276
Practice Address - Country:US
Practice Address - Phone:916-780-7676
Practice Address - Fax:916-780-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA524911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty