Provider Demographics
NPI:1073351292
Name:ZAND, ANA CALLES (DMD, MSD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:CALLES
Last Name:ZAND
Suffix:
Gender:F
Credentials:DMD, MSD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:FERNANDA
Other - Last Name:CALLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MSD
Mailing Address - Street 1:8 CHAPEL COVE CT
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-1562
Mailing Address - Country:US
Mailing Address - Phone:336-692-1042
Mailing Address - Fax:
Practice Address - Street 1:1713 NOVATO BLVD
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94947-3014
Practice Address - Country:US
Practice Address - Phone:415-897-3141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1043961223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics