Provider Demographics
NPI:1306181474
Name:SANDERSON AND ZARGARIAN DENTAL CORP.
Entity type:Organization
Organization Name:SANDERSON AND ZARGARIAN DENTAL CORP.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARGARIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:661-350-3346
Mailing Address - Street 1:2014 W. AVE K
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-5229
Mailing Address - Country:US
Mailing Address - Phone:661-729-2990
Mailing Address - Fax:661-206-6810
Practice Address - Street 1:2014 W. AVE K
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-5229
Practice Address - Country:US
Practice Address - Phone:661-729-2990
Practice Address - Fax:661-206-6810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-30
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48480122300000X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA48480OtherCALIFORNIA DENTAL BOARD
CA1063541985OtherNATIONAL PROVIDER NUMBER
CA50845OtherCALIFORNIA DENTAL BOARD