Carlos X Zambrano, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

30.026532 Issued in OH

Practice address

331 Sijan Ave
Whiteman AFB, MO 65305

Phone

(660) 687-6619

NPI assigned

Mar 16, 2021

Last updated

Aug 19, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1770168221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11457 MAYFIELD RD APT 757",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441065909",
            "telephone_number": "951-526-7735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SIJAN AVE",
            "city": "WHITEMAN AFB",
            "state": "MO",
            "postal_code": "65305",
            "telephone_number": "660-687-6619"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9601 Chester Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441061666",
            "country_code": "US",
            "telephone_number": "951-526-7735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZAMBRANO",
        "first_name": "CARLOS",
        "middle_name": "X",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.026532",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory D Watson, LCSW
• Glenda M Wilcox, LCSW
• William Arthur Winslow II, RDH
• Rebecca Gail Yasunaga, PHD
• David Andrew Yosick

• Dentist in Whiteman AFB, MO
• Providers in Whiteman AFB, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.