Provider Demographics
NPI:1891679791
Name:DZAMBAZOVIC, ANA ISABEL (RDH)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:ISABEL
Last Name:DZAMBAZOVIC
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:ISABEL
Other - Last Name:CRUZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:3046 E MARCONI AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-8349
Mailing Address - Country:US
Mailing Address - Phone:718-696-9190
Mailing Address - Fax:
Practice Address - Street 1:3046 E MARCONI AVE APT 206
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-8349
Practice Address - Country:US
Practice Address - Phone:718-696-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZH011118124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist