Provider Demographics
NPI:1891906624
Name:MARKZAR, SAM SIAMAK (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAM
Middle Name:SIAMAK
Last Name:MARKZAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:SAM
Other - Middle Name:SIAMAK
Other - Last Name:MARGHZAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:18156 E COLIMA ROAD
Mailing Address - Street 2:
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748
Mailing Address - Country:US
Mailing Address - Phone:626-965-0971
Mailing Address - Fax:626-965-5785
Practice Address - Street 1:8500 WILSHIRE BLVD
Practice Address - Street 2:SUITE 819
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211
Practice Address - Country:US
Practice Address - Phone:310-360-7570
Practice Address - Fax:310-360-1098
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA419541223P0300X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223P0300XDental ProvidersDentistPeriodontics