MEDICARE: EVAN L. ZINGARO, DDS, PLLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1841809498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVAN L. ZINGARO, DDS, PLLC

Provider Business Mailing Address
First Line	:	3448 NIAGARA FALLS BLVD
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-1244
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3448 NIAGARA FALLS BLVD
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-1244
Country	:	US
Telephone Number	:	716-807-0999
Fax Number	:

Authorized Official
Title or Position	:	MANAGING OWNER/DENTIST
Name	:	EVAN ZINGARO
Credential	:
Telephone Number	:	716-550-3885

Provider Enumeration Date	:	07/29/2020
Last Update Date	:	07/29/2020

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