Healthcare Provider Details

I. General information

NPI: 1548791486
Provider Name (Legal Business Name): ZACHARY D MAYER DDS, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2017
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 E OSBORN RD STE 206
SCOTTSDALE AZ
85251-6442
US

IV. Provider business mailing address

7555 E OSBORN RD STE 206
SCOTTSDALE AZ
85251-6442
US

V. Phone/Fax

Practice location:
  • Phone: 480-634-4013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD011015
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: