Provider Demographics
NPI:1508056136
Name:ZAVULUNOVA, ANGELA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:
Last Name:ZAVULUNOVA
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 1:6830 RIDGE BLVD
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-5831
Mailing Address - Country:US
Mailing Address - Phone:718-333-5185
Mailing Address - Fax:718-333-5237
Practice Address - Street 1:6830 RIDGE BLVD
Practice Address - Street 2:SUITE 1B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5831
Practice Address - Country:US
Practice Address - Phone:718-333-5185
Practice Address - Fax:718-333-5237
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0526531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice