Provider Demographics
NPI:1235669615
Name:ZITOUNI, SIMA (DDS)
Entity Type:Individual
Prefix:
First Name:SIMA
Middle Name:
Last Name:ZITOUNI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13231 NICHOLAS CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-5134
Mailing Address - Country:US
Mailing Address - Phone:402-651-9341
Mailing Address - Fax:402-552-2330
Practice Address - Street 1:320 MCKENZIE AVE STE 207
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-1002
Practice Address - Country:US
Practice Address - Phone:712-435-0992
Practice Address - Fax:402-552-2330
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-18
Last Update Date:2017-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-093421223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics