Provider Demographics
NPI:1265836746
Name:KAVENDEK, CRISTINA MICHELLE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRISTINA
Middle Name:MICHELLE
Last Name:KAVENDEK
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 1:15 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-9714
Mailing Address - Country:US
Mailing Address - Phone:908-601-2834
Mailing Address - Fax:
Practice Address - Street 1:15 COLUMBIA DR
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-9714
Practice Address - Country:US
Practice Address - Phone:908-601-2834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-13
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI025783001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice