Provider Demographics
NPI:1043308240
Name:ZOKAEI, AFSANEH (DDS)
Entity type:Individual
Prefix:DR
First Name:AFSANEH
Middle Name:
Last Name:ZOKAEI
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 1:4276 54TH PL. #A
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92115
Mailing Address - Country:US
Mailing Address - Phone:619-286-6909
Mailing Address - Fax:619-286-1199
Practice Address - Street 1:4276 54TH PL. #A
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92115
Practice Address - Country:US
Practice Address - Phone:619-286-6909
Practice Address - Fax:619-286-1199
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA445611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice