Healthcare Provider Details

I. General information

NPI: 1487192985
Provider Name (Legal Business Name): DZANA ESTEVES CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2017
Last Update Date: 01/17/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2682 TRANQUILLA WAY
DULUTH GA
30097-4992
US

IV. Provider business mailing address

2682 TRANQUILLA WAY
DULUTH GA
30097-4992
US

V. Phone/Fax

Practice location:
  • Phone: 404-820-2324
  • Fax: 678-585-1136
Mailing address:
  • Phone: 404-820-2324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number4920
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: