Provider Demographics
NPI:1992998496
Name:ZIESE, SIRI KATE (DDS)
Entity type:Individual
Prefix:DR
First Name:SIRI
Middle Name:KATE
Last Name:ZIESE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SIRI
Other - Middle Name:KATE
Other - Last Name:HARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1008 FOWLER WAY STE A
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-5701
Mailing Address - Country:US
Mailing Address - Phone:530-622-2862
Mailing Address - Fax:530-622-2072
Practice Address - Street 1:1008 FOWLER WAY STE A
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-5701
Practice Address - Country:US
Practice Address - Phone:530-622-2862
Practice Address - Fax:530-622-2072
Is Sole Proprietor?:No
Enumeration Date:2007-08-20
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA561471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice