Provider Demographics
NPI:1942427265
Name:ZIKRY, MAUREEN FAYEK (DDS,BDS)
Entity Type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:FAYEK
Last Name:ZIKRY
Suffix:
Gender:F
Credentials:DDS,BDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 20TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1749
Mailing Address - Country:US
Mailing Address - Phone:310-392-7468
Mailing Address - Fax:
Practice Address - Street 1:1230 SAN FERNANDO RD STE B
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-3223
Practice Address - Country:US
Practice Address - Phone:818-365-1245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA424561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice