Individual provider Active NPI

Ilya Zak, DDS

  • Dentist
  • Santa Clarita, CA
National Provider Identifier
1023165255
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38238 Issued in CA
Practice address
26324 Bouquet Canyon Rd
Santa Clarita, CA 91350-2308
Phone
(661) 253-4000
Fax
(661) 253-4063
NPI assigned
Jan 3, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38238 CA Primary

Addresses

Primary practice location

26324 Bouquet Canyon Rd
Santa Clarita, CA 91350-2308

Mailing address

26324 Bouquet Canyon Rd
Santa Clarita, CA 91350-2308
Phone (661) 253-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151006002002 CA Practitioner - Oral Surgery 4385952944 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Nov 5, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist CurrentSince Nov 5, 2023 Accepting new patients
I Zak DDS Prof Dental Corp Dentist Current Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist PastSince Apr 3, 2022 Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients
I Zak DDS Prof Dental Corp Dentist Past Accepting new patients

Locations

10501 Lakewood Blvd
#B
Downey, CA 90241
Phone (562) 862-2341

4167 Ohio St
San Diego, CA 92104
Phone (619) 281-6635

5168 Hollister Ave
Santa Barbara, CA 93111
Phone (805) 683-5300

3355 Cochran St
Ste 206
Simi Valley, CA 93063
Phone (805) 520-1100

41593 Winchester Rd
Ste 211
Temecula, CA 92590
Phone (562) 862-2341

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023165255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26324 BOUQUET CANYON RD",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502308",
            "telephone_number": "661-253-4000",
            "fax_number": "661-253-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26324 BOUQUET CANYON RD",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502308",
            "telephone_number": "661-253-4000",
            "fax_number": "661-253-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAK",
        "first_name": "ILYA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clarita, CA

Sources for this page

Verify at the official NPI Registry.