Provider Demographics
NPI:1063993327
Name:ZYLSTRA, ZACHARY VAUGHN (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:VAUGHN
Last Name:ZYLSTRA
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14620 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5429
Mailing Address - Country:US
Mailing Address - Phone:210-697-7377
Mailing Address - Fax:
Practice Address - Street 1:14620 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5429
Practice Address - Country:US
Practice Address - Phone:210-697-7377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TX41722122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician