Provider Demographics
NPI:1851189427
Name:EVANGELISTA, ZACHARY PAYTON (DDS)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:PAYTON
Last Name:EVANGELISTA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11712 KELSEY CT
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-4186
Mailing Address - Country:US
Mailing Address - Phone:909-693-1130
Mailing Address - Fax:
Practice Address - Street 1:923 N MILPAS ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93103-2331
Practice Address - Country:US
Practice Address - Phone:805-884-1998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program