Provider Demographics
NPI:1033491634
Name:SICAT, ZARINA RAE BALILO (DDS)
Entity Type:Individual
Prefix:
First Name:ZARINA RAE
Middle Name:BALILO
Last Name:SICAT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 W LAKE MEAD PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89015-7286
Mailing Address - Country:US
Mailing Address - Phone:702-464-3090
Mailing Address - Fax:702-464-3158
Practice Address - Street 1:366 W LAKE MEAD PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89015-7286
Practice Address - Country:US
Practice Address - Phone:702-464-3090
Practice Address - Fax:702-464-3158
Is Sole Proprietor?:No
Enumeration Date:2011-09-09
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0083221223G0001X
NV63731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice