Zola Dental Medford LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D9209 Issued in OR

Legal business name

ZOLA DENTAL MEDFORD LLC

Practice address

922 E Main
Medford, OR 97504

Phone

(509) 475-5367

NPI assigned

Apr 19, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Anthony Mark Paventy, DMD

Title

Owner

Phone

(509) 475-5367

Specialties & licenses 1

Addresses

Other names 1

• Boldt Dental Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1524096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524096000000",
    "number": "1437646908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 E MAIN ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 E MAIN",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "509-475-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZOLA DENTAL MEDFORD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A",
        "authorized_official_last_name": "PAVENTY",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-475-5367",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boldt Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Boldt Dental",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Marissa Nicole Ziegler
• Rebecca Zilk, MA, CCC-SLP
• Jeffery Dale Zimmer, DPM
• Sonjja Denise Zimmer, PSS
• Melissa Olena Zivanov, MSW
• Zola Dental, LLC
• Anastasia Olga Zukowski
• Sabrina Lee Zuppe
• Anna Zurek, MFT
• Rebecca A Zwart

• Dentist in Medford, OR
• Providers in Medford, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.