Provider Demographics
NPI:1407985260
Name:ALI-RUBAIE, ZAINAB (DDS)
Entity Type:Individual
Prefix:
First Name:ZAINAB
Middle Name:
Last Name:ALI-RUBAIE
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 1:471 VALLEY RD NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1028
Mailing Address - Country:US
Mailing Address - Phone:626-390-5669
Mailing Address - Fax:
Practice Address - Street 1:4203 GAGE AVE
Practice Address - Street 2:
Practice Address - City:BELL
Practice Address - State:CA
Practice Address - Zip Code:90201-1212
Practice Address - Country:US
Practice Address - Phone:323-312-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA201242170OtherCORPORATION TAX ID
CAG9312001OtherDENTICAL GROUP NUMBER