Provider Demographics
NPI:1457800344
Name:ALHAMBRA FAMILY DENTISTRY INC.
Entity Type:Organization
Organization Name:ALHAMBRA FAMILY DENTISTRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WEDAD
Authorized Official - Middle Name:M
Authorized Official - Last Name:ZAKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-282-4119
Mailing Address - Street 1:600 W MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-3336
Mailing Address - Country:US
Mailing Address - Phone:626-282-4119
Mailing Address - Fax:626-282-5896
Practice Address - Street 1:600 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-3336
Practice Address - Country:US
Practice Address - Phone:626-282-4119
Practice Address - Fax:626-282-5896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-03
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty