Provider Demographics
NPI:1083728919
Name:ZONAN, DANIEL JED (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JED
Last Name:ZONAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1910
Mailing Address - Country:US
Mailing Address - Phone:914-948-8111
Mailing Address - Fax:914-948-8111
Practice Address - Street 1:116 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1910
Practice Address - Country:US
Practice Address - Phone:914-948-8111
Practice Address - Fax:914-948-8111
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY351011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice