Provider Demographics
NPI:1285462804
Name:ZARGAR, PARISA
Entity type:Individual
Prefix:
First Name:PARISA
Middle Name:
Last Name:ZARGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 ADELLE ST
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-6353
Mailing Address - Country:US
Mailing Address - Phone:415-640-1889
Mailing Address - Fax:
Practice Address - Street 1:6660 LONE TREE WAY STE 7
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5310
Practice Address - Country:US
Practice Address - Phone:925-513-8363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110357122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist