Provider Demographics
NPI:1043664287
Name:ZELKO, AMY (DDS)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:ZELKO
Suffix:
Gender:F
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:W236S4630 WHISPERING HILLS CT
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-9774
Mailing Address - Country:US
Mailing Address - Phone:262-565-8298
Mailing Address - Fax:
Practice Address - Street 1:2126 BELLS HWY
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-6817
Practice Address - Country:US
Practice Address - Phone:262-565-8298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-13
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC92471223G0001X
SC9931223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice