Individual provider Active NPI

Andrea G. Ferreira Zandona, DDS

  • General Practice Dentistry
  • Columbus, OH
National Provider Identifier
1568743839
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
71.000282 Issued in OH
Practice address
Ohio State Dental Facility Practice
305 W. 12TH Ave., Room 2301
Columbus, OH 43210-1267
Phone
(614) 292-1472
Fax
(614) 688-3553
NPI assigned
Aug 31, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DF11903 MA
Dentist 122300000X 2000025400379 NC
General Practice Dentistry 1223G0001X 71.000282 OH Primary

Addresses

Primary practice location

Ohio State Dental Facility Practice
305 W. 12TH Ave., Room 2301
Columbus, OH 43210-1267

Mailing address

305 W 12TH Ave
Columbus, OH 43210-1267
Phone (614) 292-1472

Other identifiers 1

IdentifierTypeStateIssuer
1568743839MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160204001434 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1153625538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DF11903MAMDDentist
2000025400379NCMDDentist
71.000282OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ohio State Dental Faculty Practice Inc Dentist PastSince Dec 3, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: azandona1542793@direct.osumc.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1568743839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 W 12TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-292-1472",
            "fax_number": "614-688-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OHIO STATE DENTAL FACILITY PRACTICE",
            "address_2": "305 W. 12TH AVE., ROOM 2301",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101267",
            "telephone_number": "614-292-1472",
            "fax_number": "614-688-3553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERREIRA ZANDONA",
        "first_name": "ANDREA",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-31",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DF11903",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "2000025400379",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "71.000282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1568743839",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.