Provider Demographics
NPI:1073661666
Name:POPOVICI, IOANA (DDS)
Entity Type:Individual
Prefix:DR
First Name:IOANA
Middle Name:
Last Name:POPOVICI
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 1:2202 GRAND CONCOURSE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-2000
Mailing Address - Country:US
Mailing Address - Phone:718-365-6389
Mailing Address - Fax:
Practice Address - Street 1:2202 GRAND CONCOURSE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-2000
Practice Address - Country:US
Practice Address - Phone:718-365-6389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053420-1122300000X
CT009432122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist