Provider Demographics
NPI:1316135247
Name:ZAKHARY, MAGED G (DDS)
Entity type:Individual
Prefix:
First Name:MAGED
Middle Name:G
Last Name:ZAKHARY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1640 NEWPORT BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3786
Mailing Address - Country:US
Mailing Address - Phone:949-200-3150
Mailing Address - Fax:949-200-3153
Practice Address - Street 1:1640 NEWPORT BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3786
Practice Address - Country:US
Practice Address - Phone:949-200-3150
Practice Address - Fax:949-200-3153
Is Sole Proprietor?:No
Enumeration Date:2007-10-04
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA31434122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist