Provider Demographics
NPI:1811399108
Name:ZUBAREV, ANNA (RDH)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:ZUBAREV
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 E 7TH AVE APT B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3324
Mailing Address - Country:US
Mailing Address - Phone:509-953-9753
Mailing Address - Fax:
Practice Address - Street 1:1612 E 7TH AVE APT B
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3324
Practice Address - Country:US
Practice Address - Phone:509-953-9753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-18
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH 60489056124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADH 60489056OtherWSDH