Provider Demographics
NPI:1487847406
Name:ZAKELJ MOELLER, REBECCA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:A
Last Name:ZAKELJ MOELLER
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 1:2685 W 14TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113-5215
Mailing Address - Country:US
Mailing Address - Phone:617-838-0676
Mailing Address - Fax:
Practice Address - Street 1:1530 SAINT CLAIR AVE NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44114-2004
Practice Address - Country:US
Practice Address - Phone:216-781-6724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-22
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.024136122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist