Provider Demographics
NPI:1063533917
Name:ZIAI, MANDANA (DDS)
Entity type:Individual
Prefix:DR
First Name:MANDANA
Middle Name:
Last Name:ZIAI
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 1:39 CEDARBROOK
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-1218
Mailing Address - Country:US
Mailing Address - Phone:714-505-9440
Mailing Address - Fax:714-505-9440
Practice Address - Street 1:39 CEDARBROOK
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1218
Practice Address - Country:US
Practice Address - Phone:714-505-9440
Practice Address - Fax:714-505-9440
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice