Provider Demographics
NPI:1881405298
Name:KONO DDS AND VANZINA DDS, A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:KONO DDS AND VANZINA DDS, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:G
Authorized Official - Last Name:VANZINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:650-323-3333
Mailing Address - Street 1:555 MIDDLEFIELD RD # 200
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2124
Mailing Address - Country:US
Mailing Address - Phone:650-323-3333
Mailing Address - Fax:650-501-6001
Practice Address - Street 1:555 MIDDLEFIELD RD # 200
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94301-2124
Practice Address - Country:US
Practice Address - Phone:650-323-3333
Practice Address - Fax:650-501-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-15
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty