Healthcare Provider Details

I. General information

NPI: 1336259050
Provider Name (Legal Business Name): JOHN N ZOTOS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 N BELT LINE #310
IRVING TX
75063
US

IV. Provider business mailing address

6230 N BELT LINE #310
IRVING TX
75063
US

V. Phone/Fax

Practice location:
  • Phone: 972-550-8272
  • Fax: 972-753-1433
Mailing address:
  • Phone: 972-550-8272
  • Fax: 972-753-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18002
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: