Provider Demographics
NPI:1710401039
Name:ZOLINA, LEA MARIA SIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEA MARIA
Middle Name:SIA
Last Name:ZOLINA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 MIRA MESA BLVD STE F
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4822
Mailing Address - Country:US
Mailing Address - Phone:858-536-7005
Mailing Address - Fax:858-536-7006
Practice Address - Street 1:9330 MIRA MESA BLVD STE F
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126
Practice Address - Country:US
Practice Address - Phone:858-536-7005
Practice Address - Fax:858-536-7006
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA440851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice