Provider Demographics
NPI:1023991759
Name:ZHANG, MONA XINRUI
Entity type:Individual
Prefix:
First Name:MONA
Middle Name:XINRUI
Last Name:ZHANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 N ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1923
Mailing Address - Country:US
Mailing Address - Phone:626-389-7616
Mailing Address - Fax:
Practice Address - Street 1:11920 GARVEY AVE
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91732-3514
Practice Address - Country:US
Practice Address - Phone:626-444-3030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112143122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist