Provider Demographics
NPI:1154513455
Name:SUAREZ, ZAIDA ELENA (DDS)
Entity type:Individual
Prefix:DR
First Name:ZAIDA
Middle Name:ELENA
Last Name:SUAREZ
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 1:5363 BALBOA BLVD
Mailing Address - Street 2:#439
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316
Mailing Address - Country:US
Mailing Address - Phone:818-784-4252
Mailing Address - Fax:818-784-7233
Practice Address - Street 1:5363 BALBOA BLVD
Practice Address - Street 2:#439
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:818-784-4252
Practice Address - Fax:818-784-7233
Is Sole Proprietor?:No
Enumeration Date:2007-08-10
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice