Provider Demographics
NPI:1508442286
Name:NESSEL, ZACHARY ANDREW (DMD)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:ANDREW
Last Name:NESSEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WHEATSHEAF FARM RD
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-3540
Mailing Address - Country:US
Mailing Address - Phone:862-258-0865
Mailing Address - Fax:
Practice Address - Street 1:4303 13TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-1337
Practice Address - Country:US
Practice Address - Phone:862-258-0865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY062828122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program