Healthcare Provider Details

I. General information

NPI: 1902858111
Provider Name (Legal Business Name): JOHN FRANK ZUMMO JR. D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16125 CAIRNWAY DR SUITE 108
HOUSTON TX
77084-3556
US

IV. Provider business mailing address

16125 CAIRNWAY DR SUITE 108
HOUSTON TX
77084-3556
US

V. Phone/Fax

Practice location:
  • Phone: 281-859-9878
  • Fax: 281-859-6720
Mailing address:
  • Phone: 281-859-9878
  • Fax: 281-859-6720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number12634
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: