Provider Demographics
NPI:1871690990
Name:ZAPATERO, DAG (DDS MAGD)
Entity Type:Individual
Prefix:DR
First Name:DAG
Middle Name:
Last Name:ZAPATERO
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:DR
Other - First Name:DAGOBERTO
Other - Middle Name:GONZALOS
Other - Last Name:ZAPATERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3020 SHORE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-1295
Mailing Address - Country:US
Mailing Address - Phone:757-481-8893
Mailing Address - Fax:757-481-0425
Practice Address - Street 1:3020 SHORE DRIVE
Practice Address - Street 2:SUITE A
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451
Practice Address - Country:US
Practice Address - Phone:757-481-8893
Practice Address - Fax:757-481-0425
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010074501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice