Provider Demographics
NPI:1689726127
Name:ZELIN, DAVID IRA (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:IRA
Last Name:ZELIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4951 B - EAST ADAMO DR.
Mailing Address - Street 2:SUITE# 222
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33605-5919
Mailing Address - Country:US
Mailing Address - Phone:813-247-6119
Mailing Address - Fax:813-247-3369
Practice Address - Street 1:4951 B - EAST ADAMO DR.
Practice Address - Street 2:SUITE# 222
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33605-5919
Practice Address - Country:US
Practice Address - Phone:813-247-6119
Practice Address - Fax:813-247-3369
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0009762122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU61696Medicare UPIN
FL64670Medicare ID - Type Unspecified