Provider Demographics
NPI:1538397161
Name:ZACHS, NEIL R (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:R
Last Name:ZACHS
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1598 BAY ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-1881
Mailing Address - Country:US
Mailing Address - Phone:480-394-1244
Mailing Address - Fax:
Practice Address - Street 1:20950 N TATUM BLVD STE 210
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-4268
Practice Address - Country:US
Practice Address - Phone:480-538-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-22
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ83711223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics