Provider Demographics
NPI:1194809046
Name:NAVE, ANDREA LYNNE ZANARDELLI (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:LYNNE ZANARDELLI
Last Name:NAVE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 BOWER HILL RD
Mailing Address - Street 2:
Mailing Address - City:VENETIA
Mailing Address - State:PA
Mailing Address - Zip Code:15367-1486
Mailing Address - Country:US
Mailing Address - Phone:724-470-8989
Mailing Address - Fax:
Practice Address - Street 1:662 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:VENETIA
Practice Address - State:PA
Practice Address - Zip Code:15367-1486
Practice Address - Country:US
Practice Address - Phone:724-470-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031244L1223P0221X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1024930860002Medicaid
PA1024930860001Medicaid