Provider Demographics
NPI:1073365342
Name:YIGAL ZIBARI, D.D.S., A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:YIGAL ZIBARI, D.D.S., A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR TEAM LEAD OF CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIAROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-869-3789
Mailing Address - Street 1:1200 ROSECRANS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2470
Mailing Address - Country:US
Mailing Address - Phone:310-615-1022
Mailing Address - Fax:
Practice Address - Street 1:1200 ROSECRANS AVE STE 101
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2470
Practice Address - Country:US
Practice Address - Phone:310-615-1022
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-02
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty