Provider Demographics
NPI:1639856677
Name:ZALAK S. DAFTARY, DDS, PLLC
Entity Type:Organization
Organization Name:ZALAK S. DAFTARY, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZALAK
Authorized Official - Middle Name:
Authorized Official - Last Name:DAFTARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-497-0542
Mailing Address - Street 1:11801 NE 36TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1247
Mailing Address - Country:US
Mailing Address - Phone:704-497-0542
Mailing Address - Fax:
Practice Address - Street 1:7317 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-9739
Practice Address - Country:US
Practice Address - Phone:425-636-8969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies