Provider Demographics
NPI:1053283754
Name:DUNBAR, ZACHARY DEAN
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:DEAN
Last Name:DUNBAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3815 SHADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-1372
Mailing Address - Country:US
Mailing Address - Phone:260-760-7635
Mailing Address - Fax:
Practice Address - Street 1:3815 SHADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-1372
Practice Address - Country:US
Practice Address - Phone:260-760-7635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86175939133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty