Provider Demographics
NPI:1811091416
Name:ZEMLYANSKY, SERGEY (DMD)
Entity type:Individual
Prefix:
First Name:SERGEY
Middle Name:
Last Name:ZEMLYANSKY
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 1:127 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-1802
Mailing Address - Country:US
Mailing Address - Phone:978-283-7200
Mailing Address - Fax:978-283-7204
Practice Address - Street 1:127 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-1802
Practice Address - Country:US
Practice Address - Phone:978-283-7200
Practice Address - Fax:978-283-7204
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA193711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice