Provider Demographics
NPI:1619264868
Name:STREIT, ZACHARY EDWARDS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:EDWARDS
Last Name:STREIT
Suffix:
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 1:22815 EDMONDS WAY
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-5041
Mailing Address - Country:US
Mailing Address - Phone:425-771-3266
Mailing Address - Fax:425-774-7917
Practice Address - Street 1:22815 EDMONDS WAY
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-5041
Practice Address - Country:US
Practice Address - Phone:425-771-3266
Practice Address - Fax:425-774-7917
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60237532122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADE60237532Other463768354