Provider Demographics
NPI:1083309447
Name:MUBARIK, ZARISH (DMD)
Entity Type:Individual
Prefix:MRS
First Name:ZARISH
Middle Name:
Last Name:MUBARIK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3021 NE 44TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-5307
Mailing Address - Country:US
Mailing Address - Phone:301-800-9696
Mailing Address - Fax:
Practice Address - Street 1:1303 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-3107
Practice Address - Country:US
Practice Address - Phone:301-478-4854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN265291223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1223G0001XDental ProvidersDentistGeneral Practice