Provider Demographics
NPI:1326321019
Name:SARAH ZIRAKZADEH DDS INC
Entity Type:Organization
Organization Name:SARAH ZIRAKZADEH DDS INC
Other - Org Name:ORTEGA DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIRAKZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-240-0250
Mailing Address - Street 1:31726 RANCHO VIEJO RD STE 109
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2723
Mailing Address - Country:US
Mailing Address - Phone:949-240-0250
Mailing Address - Fax:949-240-0201
Practice Address - Street 1:31726 RANCHO VIEJO RD # B109
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-2779
Practice Address - Country:US
Practice Address - Phone:949-240-0250
Practice Address - Fax:949-240-0201
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARAH ZIRAKZADEH DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46007302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization