Provider Demographics
NPI:1164510715
Name:DR. ZIEMBA
Entity Type:Organization
Organization Name:DR. ZIEMBA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ARACELI
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZIEMBA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-297-0588
Mailing Address - Street 1:1626 ROUTE 130
Mailing Address - Street 2:LIONS PLAZA
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902
Mailing Address - Country:US
Mailing Address - Phone:732-297-0588
Mailing Address - Fax:732-297-2565
Practice Address - Street 1:1626 ROUTE 130
Practice Address - Street 2:LIONS PLAZA
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902
Practice Address - Country:US
Practice Address - Phone:732-297-0588
Practice Address - Fax:732-297-2565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI169941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========OtherTAX ID