Provider Demographics
NPI:1700439080
Name:PLOSS, MEGAN ZARINA (DMD)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ZARINA
Last Name:PLOSS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 NAUTILUS ST APT 302
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5971
Mailing Address - Country:US
Mailing Address - Phone:520-841-2832
Mailing Address - Fax:
Practice Address - Street 1:17487 S HEALTHCARE DR
Practice Address - Street 2:
Practice Address - City:LAVEEN
Practice Address - State:AZ
Practice Address - Zip Code:85339-8500
Practice Address - Country:US
Practice Address - Phone:520-550-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0104411223G0001X
CADDS1106051223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice