Provider Demographics
NPI:1396521449
Name:ZABALEGUI MARCO, ALICIA (DMD)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:
Last Name:ZABALEGUI MARCO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 11TH ST NW PH 1
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-5068
Mailing Address - Country:US
Mailing Address - Phone:213-655-7408
Mailing Address - Fax:
Practice Address - Street 1:715 PENDLETON ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-1820
Practice Address - Country:US
Practice Address - Phone:571-970-3783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014186141223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics