Provider Demographics
NPI:1487213393
Name:ZINNIA CARLOS REGALA DDS APC
Entity Type:Organization
Organization Name:ZINNIA CARLOS REGALA DDS APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZINNIA
Authorized Official - Middle Name:CARLOS
Authorized Official - Last Name:REGALA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-846-8564
Mailing Address - Street 1:2625 W ALAMEDA AVE STE 216
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4823
Mailing Address - Country:US
Mailing Address - Phone:818-846-8564
Mailing Address - Fax:
Practice Address - Street 1:2625 W ALAMEDA AVE STE 216
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4823
Practice Address - Country:US
Practice Address - Phone:818-846-8564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty