Provider Demographics
NPI:1831286491
Name:ZUNIGA, JACOB (DDS)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:
Last Name:ZUNIGA
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 1:33 N LINDSAY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-5807
Mailing Address - Country:US
Mailing Address - Phone:480-539-7323
Mailing Address - Fax:480-539-2968
Practice Address - Street 1:33 N LINDSAY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-4591
Practice Address - Country:US
Practice Address - Phone:480-539-7323
Practice Address - Fax:480-539-2968
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD45501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice