Provider Demographics
NPI:1366890139
Name:DAFTARY, ZALAK (DDS)
Entity type:Individual
Prefix:DR
First Name:ZALAK
Middle Name:
Last Name:DAFTARY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11801 NE 36TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1247
Mailing Address - Country:US
Mailing Address - Phone:704-497-0542
Mailing Address - Fax:
Practice Address - Street 1:7317 NE 141ST ST
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-9739
Practice Address - Country:US
Practice Address - Phone:425-636-8969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-02
Last Update Date:2023-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE606384761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice