Healthcare Provider Details

I. General information

NPI: 1962453050
Provider Name (Legal Business Name): JOHN F. ZUMMO JR. D.D.S, P.C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 08/22/2020
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: DR. JOHN F. ZUMMO JR.
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 281-859-9878