Provider Demographics
NPI:1891222642
Name:KENDRA J. ZAPPIA, DDS, LLC
Entity Type:Organization
Organization Name:KENDRA J. ZAPPIA, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZAPPIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:518-869-1138
Mailing Address - Street 1:3 PINE WEST PLZ
Mailing Address - Street 2:SUITE 306
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-5519
Mailing Address - Country:US
Mailing Address - Phone:518-869-1138
Mailing Address - Fax:518-869-5679
Practice Address - Street 1:3 PINE WEST PLZ
Practice Address - Street 2:SUITE 306
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5519
Practice Address - Country:US
Practice Address - Phone:518-869-1138
Practice Address - Fax:518-869-5679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY052786122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty