Provider Demographics
NPI:1144650052
Name:AMY A ZONOOZI DDS INC
Entity type:Organization
Organization Name:AMY A ZONOOZI DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZONOOZI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:909-391-4300
Mailing Address - Street 1:2905 S EUCLID AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-6684
Mailing Address - Country:US
Mailing Address - Phone:909-391-4300
Mailing Address - Fax:909-391-4311
Practice Address - Street 1:2905 S EUCLID AVE STE D
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762-6684
Practice Address - Country:US
Practice Address - Phone:909-391-4300
Practice Address - Fax:909-391-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39504122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty