Provider Demographics
NPI:1356544571
Name:ZEITOUNE, TAREK GM (DDS)
Entity type:Individual
Prefix:DR
First Name:TAREK
Middle Name:GM
Last Name:ZEITOUNE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 17TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-7300
Mailing Address - Country:US
Mailing Address - Phone:949-515-8181
Mailing Address - Fax:949-515-8132
Practice Address - Street 1:204 E 17TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-7300
Practice Address - Country:US
Practice Address - Phone:949-515-8181
Practice Address - Fax:949-515-8132
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA403271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice