Provider Demographics
NPI:1770571762
Name:ZAAYENGA, N. WAYNE (DMD)
Entity type:Individual
Prefix:DR
First Name:N. WAYNE
Middle Name:
Last Name:ZAAYENGA
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 1:1302 SHIP RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1308
Mailing Address - Country:US
Mailing Address - Phone:610-431-9651
Mailing Address - Fax:610-431-9759
Practice Address - Street 1:1302 SHIP RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-1308
Practice Address - Country:US
Practice Address - Phone:610-431-9651
Practice Address - Fax:610-431-9759
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026024L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice