NPIMap

Organization Active NPI

I Zak DDS Prof Dental Corp

Doing business as Dr. Zak La Mirada Dental Care

  • Dentist
  • Whittier, CA
National Provider Identifier
1285287631
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
I ZAK DDS PROF DENTAL CORP
Doing business as
Dr. Zak La Mirada Dental Care
Dr. Zak Whittier Dental Care
Zak Dental, Practice of I. ZAK D.D.S. PROF. DENTAL CORP.
Practice address
9229 Colima Rd
Whittier, CA 90605-1809
Phone
(562) 947-3761
NPI assigned
Jul 24, 2019
Last updated
Oct 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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

Authorized official

Name
Ilya Zak, DDSNPI 1023165255
Title
Ceo, Dentist
Phone
(310) 503-9277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary
Endodontics 1223E0200X
General Practice Dentistry 1223G0001X
Oral and Maxillofacial Pathology Dentistry 1223P0106X
Pediatric Dentistry 1223P0221X
Periodontics 1223P0300X
Prosthodontics 1223P0700X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X

Addresses

Primary practice location

9229 Colima Rd
Whittier, CA 90605-1809

Mailing address

10501 Lakewood Blvd
Downey, CA 90241-2709
Phone (310) 503-9277

Other names 3

  • Dr. Zak La Mirada Dental Care Doing business as
  • Dr. Zak Whittier Dental Care Doing business as
  • Zak Dental, Practice of I. ZAK D.D.S. PROF. DENTAL CORP. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231220003181 CA Part B Supplier - Clinic/Group Practice 9133579808 Receives reassigned benefits from 20 practitioners
11 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Temecula, CA; Whittier, CA; Ventura, CA; Valencia, CA; Simi Valley, CA; Santa Barbara, CA; San Diego, CA; Long Beach, CA…

Other NPIs on the same Medicare enrollment 11

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
I Zak DDS Prof Dental Corp14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

11900 La Mirada Blvd
Ste 7
La Mirada, CA 90638
Phone (562) 947-3761

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1563926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635465600000",
    "number": "1285287631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 LAKEWOOD BLVD",
            "city": "DOWNEY",
            "state": "CA",
            "postal_code": "902412709",
            "telephone_number": "310-503-9277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 COLIMA RD",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906051809",
            "telephone_number": "562-947-3761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I ZAK DDS PROF DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-24",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A",
        "authorized_official_last_name": "ZAK",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "CEO, DENTIST",
        "authorized_official_telephone_number": "310-503-9277",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Zak La Mirada Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr. Zak Whittier Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dr. Zak Whittier Dental Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Zak Dental, Practice of I. ZAK D.D.S. PROF. DENTAL CORP.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Whittier, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.