Provider Demographics
NPI:1205989829
Name:ZINBERG, DIANA (DDS)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:ZINBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 E GAGE AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-4121
Mailing Address - Country:US
Mailing Address - Phone:132-358-8825
Mailing Address - Fax:323-588-2199
Practice Address - Street 1:2629 E GAGE AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-4121
Practice Address - Country:US
Practice Address - Phone:132-358-8825
Practice Address - Fax:323-588-2199
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA393591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice