Provider Demographics
NPI:1366655201
Name:OWAIS, ZAIDOON R (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ZAIDOON
Middle Name:R
Last Name:OWAIS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 W. CAPITOL EXPWY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95136
Mailing Address - Country:US
Mailing Address - Phone:408-448-3888
Mailing Address - Fax:408-448-3895
Practice Address - Street 1:511 W. CAPITOL EXPWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95136
Practice Address - Country:US
Practice Address - Phone:408-448-3888
Practice Address - Fax:408-448-3895
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA555241223G0001X, 122300000X
MND118121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice