Provider Demographics
NPI:1972591162
Name:ZALTSGENDLER, IRINA (DDS)
Entity type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:ZALTSGENDLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6230 10TH ST N
Mailing Address - Street 2:SUITE 520
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-6158
Mailing Address - Country:US
Mailing Address - Phone:651-731-3064
Mailing Address - Fax:651-731-9340
Practice Address - Street 1:6230 10TH ST N
Practice Address - Street 2:SUITE 520
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-6158
Practice Address - Country:US
Practice Address - Phone:651-731-3064
Practice Address - Fax:651-731-9340
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN111971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice