Provider Demographics
NPI:1811560766
Name:SIEGLER, ZACHARY (DDS)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:SIEGLER
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 1:4619 E 108TH PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-6857
Mailing Address - Country:US
Mailing Address - Phone:918-232-1042
Mailing Address - Fax:
Practice Address - Street 1:6565 S YALE AVE STE 712
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-8308
Practice Address - Country:US
Practice Address - Phone:918-481-6622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK831223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty