Provider Demographics
NPI:1548425481
Name:BRIAN A. ZARIKTA, DDS
Entity Type:Organization
Organization Name:BRIAN A. ZARIKTA, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARIKTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:575-762-4501
Mailing Address - Street 1:813 PARKLAND DR
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101-4430
Mailing Address - Country:US
Mailing Address - Phone:575-762-4501
Mailing Address - Fax:575-762-7430
Practice Address - Street 1:813 PARKLAND DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4430
Practice Address - Country:US
Practice Address - Phone:575-762-4501
Practice Address - Fax:575-762-7430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD12161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty