Healthcare Provider Details

I. General information

NPI: 1477916211
Provider Name (Legal Business Name): JOSEPH ZINGALE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2016
Last Update Date: 03/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 SHEILA CT
MORAGA CA
94556-1731
US

IV. Provider business mailing address

236 SHEILA CT
MORAGA CA
94556-1731
US

V. Phone/Fax

Practice location:
  • Phone: 925-376-9624
  • Fax:
Mailing address:
  • Phone: 925-376-9624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number20492
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: