Active NPI
Mena Nashat Adly Zaky, DDS
- Dentist
- Loma Linda, CA
National Provider Identifier
1730965302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 109220
- Practice address
- 11092 Anderson St
Loma Linda, CA 92350-1706 - Phone
- (909) 558-4671
- NPI assigned
- Sep 7, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 109220 | CA | Primary |
Addresses
Primary practice location
11092 Anderson St
Loma Linda, CA 92350-1706
Mailing address
25241 La Mar Rd Apt a
Loma Linda, CA 92354-3021
Phone (248) 891-9092
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109220 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1730965302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25241 LA MAR RD APT A",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543021",
"telephone_number": "248-891-9092"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11092 ANDERSON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923501706",
"telephone_number": "909-558-4671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZAKY",
"first_name": "MENA",
"middle_name": "NASHAT ADLY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-09-07",
"last_updated": "2023-09-07",
"certification_date": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "109220",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.