Provider Demographics
NPI:1417306648
Name:CUMMINGS, ZAZELL STAHELI (DDS)
Entity Type:Individual
Prefix:
First Name:ZAZELL
Middle Name:STAHELI
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ZAZELL
Other - Middle Name:
Other - Last Name:STAHELI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 28
Mailing Address - Street 2:
Mailing Address - City:KOTZEBUE
Mailing Address - State:AK
Mailing Address - Zip Code:99752-0028
Mailing Address - Country:US
Mailing Address - Phone:907-590-8757
Mailing Address - Fax:
Practice Address - Street 1:436 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:KOTZEBUE
Practice Address - State:AK
Practice Address - Zip Code:99752
Practice Address - Country:US
Practice Address - Phone:907-442-7326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK115410122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist