Provider Demographics
NPI:1780797092
Name:ZONOOZI, AMY A (DDS)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:A
Last Name:ZONOOZI
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 1:2905 S EUCLID
Mailing Address - Street 2:STE D
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762
Mailing Address - Country:US
Mailing Address - Phone:909-391-4300
Mailing Address - Fax:909-391-4311
Practice Address - Street 1:2905 S EUCLID
Practice Address - Street 2:STE D
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762
Practice Address - Country:US
Practice Address - Phone:909-391-4300
Practice Address - Fax:909-391-4311
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA395041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice