Provider Demographics
NPI:1558415661
Name:ZEIP, PHILLIP S JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:PHILLIP
Middle Name:S
Last Name:ZEIP
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 MISSION DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95065-1868
Mailing Address - Country:US
Mailing Address - Phone:831-475-3853
Mailing Address - Fax:831-475-3960
Practice Address - Street 1:3315 MISSION DR
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1868
Practice Address - Country:US
Practice Address - Phone:831-475-3853
Practice Address - Fax:831-475-3960
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43411122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist