Healthcare Provider Details

I. General information

NPI: 1801636105
Provider Name (Legal Business Name): ZACHARY ZAPATA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2024
Last Update Date: 05/27/2024
Certification Date: 05/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6034 S 16TH ST
PHOENIX AZ
85042-4465
US

IV. Provider business mailing address

441 S LABELLE
MESA AZ
85208-7489
US

V. Phone/Fax

Practice location:
  • Phone: 602-845-3333
  • Fax:
Mailing address:
  • Phone: 480-306-9678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD012153
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: