MEDICARE: JOHN R ZUNIGA DDS/PHD

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	122300000X	Dentist	22546	TX
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	22546	TX

General Provider Information

NPI Number	:	1588660856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R ZUNIGA DDS/PHD

Provider Business Mailing Address
First Line	:	UTSW BILLING
Second Line	:	P.O. BOX 845347
City	:	DALLAS
State	:	TX
Zip	:	75284-0001
Country	:	US
Telephone Number	:	214-645-0600
Fax Number	:	214-645-2762

Provider Business Practice Location Address
First Line	:	ORAL AND MAXILLOFACIAL SURGERY
Second Line	:	5939 HARRY HINES BLVD, #210
City	:	DALLAS
State	:	TX
Zip	:	75390-0001
Country	:	US
Telephone Number	:	214-645-3999
Fax Number	:	214-645-3989

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	04/25/2025

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