Provider Demographics
NPI:1508871021
Name:ZINGALE, KATHLEEN COX (DDS)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:COX
Last Name:ZINGALE
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 1:125 E BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:ELYRIA
Mailing Address - State:OH
Mailing Address - Zip Code:44035-5218
Mailing Address - Country:US
Mailing Address - Phone:440-322-7212
Mailing Address - Fax:440-322-1182
Practice Address - Street 1:125 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:ELYRIA
Practice Address - State:OH
Practice Address - Zip Code:44035-5218
Practice Address - Country:US
Practice Address - Phone:440-322-7212
Practice Address - Fax:440-322-1182
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH203341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH226728Medicaid