Provider Demographics
NPI:1699837823
Name:ZARINNIA, MATT
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:ZARINNIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16133 VENTURA BLVD STE 1100
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2415
Mailing Address - Country:US
Mailing Address - Phone:310-867-0636
Mailing Address - Fax:
Practice Address - Street 1:16133 VENTURA BLVD STE 1100
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2415
Practice Address - Country:US
Practice Address - Phone:310-867-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA554001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice