Healthcare Provider Details

I. General information

NPI: 1508274499
Provider Name (Legal Business Name): CASSANDRA MAE ZELENAK D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2014
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N PIKE ST
GRAFTON WV
26354-1221
US

IV. Provider business mailing address

711 N PIKE ST
GRAFTON WV
26354-1221
US

V. Phone/Fax

Practice location:
  • Phone: 304-265-4600
  • Fax: 304-265-6008
Mailing address:
  • Phone: 304-376-5728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4119
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: