Provider Demographics
NPI:1073123139
Name:BABAKULOVA, ZARRINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZARRINA
Middle Name:
Last Name:BABAKULOVA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ZARRINA
Other - Middle Name:
Other - Last Name:BABAKULOVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:1 TIFFANY PT STE 209
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2916
Mailing Address - Country:US
Mailing Address - Phone:630-884-4131
Mailing Address - Fax:
Practice Address - Street 1:1 TIFFANY PT STE 209
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2916
Practice Address - Country:US
Practice Address - Phone:630-884-4131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-04
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0326711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice