Provider Demographics
NPI:1104031525
Name:LANDIG, HECTOR ZARI (DMD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:ZARI
Last Name:LANDIG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 GRAND AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4447
Mailing Address - Country:US
Mailing Address - Phone:909-396-5161
Mailing Address - Fax:909-396-5165
Practice Address - Street 1:1241 GRAND AVE
Practice Address - Street 2:SUITE G
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-4447
Practice Address - Country:US
Practice Address - Phone:909-396-5161
Practice Address - Fax:909-396-5165
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36570122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1104031525Medicaid
CAG90510OtherDENTI-CAL