Provider Demographics
NPI:1598859514
Name:JEFFRIES, ZENA GERMAINE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ZENA
Middle Name:GERMAINE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1805
Mailing Address - Country:US
Mailing Address - Phone:412-681-5070
Mailing Address - Fax:412-682-4734
Practice Address - Street 1:4929 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1805
Practice Address - Country:US
Practice Address - Phone:412-681-5070
Practice Address - Fax:412-682-4734
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029919L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAJEO49998OtherBCBS
PA0016111280001Medicaid