Healthcare Provider Details

I. General information

NPI: 1508313560
Provider Name (Legal Business Name): ZUZANNA ROSSA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PORTLAND ST
COLUMBIA MO
65201-6525
US

IV. Provider business mailing address

200 PORTLAND ST
COLUMBIA MO
65201-6525
US

V. Phone/Fax

Practice location:
  • Phone: 660-717-7070
  • Fax:
Mailing address:
  • Phone: 660-717-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD010611
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number0401415223
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2024006974
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: