Provider Demographics
NPI:1144403148
Name:ZILBERMAN, SUSANNA NICOLE (DDS)
Entity Type:Individual
Prefix:
First Name:SUSANNA
Middle Name:NICOLE
Last Name:ZILBERMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 W 20TH ST STE 702
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-2433
Mailing Address - Country:US
Mailing Address - Phone:713-868-2721
Mailing Address - Fax:713-862-1199
Practice Address - Street 1:427 W 20TH ST STE 702
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-2433
Practice Address - Country:US
Practice Address - Phone:713-868-2721
Practice Address - Fax:713-862-1199
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-12
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23367122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist