Provider Demographics
NPI:1629185392
Name:AZAR, ZAIHLY L (DDS)
Entity Type:Individual
Prefix:
First Name:ZAIHLY
Middle Name:L
Last Name:AZAR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ZAIHLY
Other - Middle Name:LISSETTE
Other - Last Name:BALDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3403 E. PLAZA BLVD.
Mailing Address - Street 2:SUITE G
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950
Mailing Address - Country:US
Mailing Address - Phone:619-267-6672
Mailing Address - Fax:619-267-6599
Practice Address - Street 1:3403 E. PLAZA BLVD.
Practice Address - Street 2:SUITE G
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950
Practice Address - Country:US
Practice Address - Phone:619-267-6672
Practice Address - Fax:619-267-6599
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA467451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice