Provider Demographics
NPI:1164257861
Name:ZELAYA, GERARDO NAPOLEON (DDS)
Entity type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:NAPOLEON
Last Name:ZELAYA
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 1:133 S MIRAGE AVE
Mailing Address - Street 2:
Mailing Address - City:LINDSAY
Mailing Address - State:CA
Mailing Address - Zip Code:93247-2541
Mailing Address - Country:US
Mailing Address - Phone:559-667-1044
Mailing Address - Fax:
Practice Address - Street 1:133 S MIRAGE AVE
Practice Address - Street 2:
Practice Address - City:LINDSAY
Practice Address - State:CA
Practice Address - Zip Code:93247-2541
Practice Address - Country:US
Practice Address - Phone:559-667-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA110659122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist