Provider Demographics
NPI:1861543134
Name:SEGAL, ZEV (DDS)
Entity type:Individual
Prefix:
First Name:ZEV
Middle Name:
Last Name:SEGAL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 2-F
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4896
Mailing Address - Country:US
Mailing Address - Phone:973-597-9010
Mailing Address - Fax:973-597-9008
Practice Address - Street 1:315 E NORTHFIELD RD
Practice Address - Street 2:SUITE 2-F
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4896
Practice Address - Country:US
Practice Address - Phone:973-597-9010
Practice Address - Fax:973-597-9008
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ190311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ22DI01903100OtherBOARD OF DENTISTRY