Provider Demographics
NPI:1043827496
Name:ZANBARAKJI, MOAZ (DMD)
Entity type:Individual
Prefix:DR
First Name:MOAZ
Middle Name:
Last Name:ZANBARAKJI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 BASSETT RD APT 5306
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MA
Mailing Address - Zip Code:01503-1720
Mailing Address - Country:US
Mailing Address - Phone:571-216-8235
Mailing Address - Fax:
Practice Address - Street 1:347 GREENWOOD ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01607-1785
Practice Address - Country:US
Practice Address - Phone:508-791-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist