Provider Demographics
NPI:1932736972
Name:OFFMAN, ZACHARY DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:DAVID
Last Name:OFFMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 GOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-2334
Mailing Address - Country:US
Mailing Address - Phone:845-659-1834
Mailing Address - Fax:
Practice Address - Street 1:6542 BRIGHT AVE
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4503
Practice Address - Country:US
Practice Address - Phone:562-693-9263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA106641122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes122300000XDental ProvidersDentist