Provider Demographics
NPI:1164267944
Name:ZAKHARY, MINA (DDS)
Entity type:Individual
Prefix:DR
First Name:MINA
Middle Name:
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 1:4639 CHASTAIN DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-1273
Mailing Address - Country:US
Mailing Address - Phone:321-507-6256
Mailing Address - Fax:
Practice Address - Street 1:300 GATLIN AVE STE 1-B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6951
Practice Address - Country:US
Practice Address - Phone:407-851-7741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice