Provider Demographics
NPI:1457696122
Name:ZAHRA SARA NADERI DDS INC
Entity Type:Organization
Organization Name:ZAHRA SARA NADERI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SARA
Authorized Official - Middle Name:ZAHRA
Authorized Official - Last Name:NADERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:858-273-1580
Mailing Address - Street 1:4241 BALBOA AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117
Mailing Address - Country:US
Mailing Address - Phone:858-273-1580
Mailing Address - Fax:858-273-3554
Practice Address - Street 1:4241 BALBOA AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117
Practice Address - Country:US
Practice Address - Phone:858-273-1580
Practice Address - Fax:858-273-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA50496261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental