Provider Demographics
NPI:1821203092
Name:ZAPATA, RICARDO A (DDS)
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:A
Last Name:ZAPATA
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 1:2915 N 59TH AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85033-5807
Mailing Address - Country:US
Mailing Address - Phone:623-846-0575
Mailing Address - Fax:
Practice Address - Street 1:2915 N 59TH AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85033-5807
Practice Address - Country:US
Practice Address - Phone:623-846-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5586122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist