Provider Demographics
NPI:1932558004
Name:RIFKIN, ZACHARY
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:
Last Name:RIFKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 ABERNATHY RD STE 330
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5613
Mailing Address - Country:US
Mailing Address - Phone:404-502-1010
Mailing Address - Fax:888-958-0213
Practice Address - Street 1:1000 ABERNATHY RD STE 330
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5613
Practice Address - Country:US
Practice Address - Phone:770-393-0800
Practice Address - Fax:888-958-0213
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-08
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GADN015622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program