Provider Demographics
NPI:1003509969
Name:ZRIK, JINA (DDS)
Entity type:Individual
Prefix:DR
First Name:JINA
Middle Name:
Last Name:ZRIK
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 1:8702 TACK ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:CO
Mailing Address - Zip Code:80504-4418
Mailing Address - Country:US
Mailing Address - Phone:703-989-1794
Mailing Address - Fax:
Practice Address - Street 1:7859 6TH ST # 150
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:CO
Practice Address - Zip Code:80549-5045
Practice Address - Country:US
Practice Address - Phone:970-568-4442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00205603122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist