MEDICARE: DUSTIN JOE ZARATE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4898	AR
2	1223G0001X	General Practice Dentistry	41664	TX
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1265131403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUSTIN JOE ZARATE

Provider Business Mailing Address
First Line	:	6651 CROWN RDG
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-1511
Country	:	US
Telephone Number	:	956-324-0382
Fax Number	:

Provider Business Practice Location Address
First Line	:	10730 POTRANCO RD STE 111
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78251-3330
Country	:	US
Telephone Number	:	210-495-2000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	01/19/2026

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Directions to “ DUSTIN JOE ZARATE ” Practice Location

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