Provider Demographics
NPI:1831611532
Name:ZAGHLOUL, MEERNA HANNA
Entity type:Individual
Prefix:
First Name:MEERNA
Middle Name:HANNA
Last Name:ZAGHLOUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25039 MOUND ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2770
Mailing Address - Country:US
Mailing Address - Phone:832-812-0911
Mailing Address - Fax:
Practice Address - Street 1:25039 MOUND ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2770
Practice Address - Country:US
Practice Address - Phone:832-812-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33127122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist