Provider Demographics
NPI:1568945962
Name:GAVIRIA, ZORAIDA DEL PILAR (DMD)
Entity Type:Individual
Prefix:
First Name:ZORAIDA
Middle Name:DEL PILAR
Last Name:GAVIRIA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ZORAIDA
Other - Middle Name:DEL PILAR
Other - Last Name:GAVIRIA RUIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:9521 SANDIFUR PKWY STE 1
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-9105
Mailing Address - Country:US
Mailing Address - Phone:509-547-1600
Mailing Address - Fax:509-547-0572
Practice Address - Street 1:9521 SANDIFUR PKWY STE 1
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-9105
Practice Address - Country:US
Practice Address - Phone:509-547-1600
Practice Address - Fax:509-547-0572
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE608616301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE60861630OtherGENERAL DENTIST