Provider Demographics
NPI:1194065649
Name:URBAN, ZHANNA (DDS)
Entity type:Individual
Prefix:DR
First Name:ZHANNA
Middle Name:
Last Name:URBAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MS
Other - First Name:ZHANNA
Other - Middle Name:
Other - Last Name:YSCHOUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2451 FM 1103 STE 109
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-1967
Mailing Address - Country:US
Mailing Address - Phone:210-957-0849
Mailing Address - Fax:210-519-3044
Practice Address - Street 1:2451 FM 1103 STE 109
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-1967
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-20
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0109131223G0001X
NJ22DI025236011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice