Provider Demographics
NPI:1073663241
Name:ZARKA, RANDA
Entity Type:Individual
Prefix:
First Name:RANDA
Middle Name:
Last Name:ZARKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4064 VILLAGE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-5673
Mailing Address - Country:US
Mailing Address - Phone:713-876-5313
Mailing Address - Fax:713-876-5313
Practice Address - Street 1:4064 VILLAGE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-5673
Practice Address - Country:US
Practice Address - Phone:713-876-5313
Practice Address - Fax:713-876-5313
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012975A1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics