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General NPI Number Information
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NPI Number | 1710722905
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Entity Type | Individual
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Provider Name | SIERRA ZARATE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2024
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Last Update Date | 12/30/2025
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Provider Practice Location Address
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Address Line | 4074 FAIRMOUNT AVE STE B
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City | SAN DIEGO
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State | CA
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Zip | 92105-1608
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Country | US
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Telephone | 619-996-9543
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Fax |
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Provider Business Mailing Address
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Address Line | 4318 CARROLLWOOD VILLAGE DR
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City | TAMPA
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State | FL
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Zip | 33618-8657
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Country | US
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Telephone | 813-417-2471
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 26301
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 112529
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License Number State | CA
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