Provider Demographics
NPI:1275759912
Name:KIRILL KVITKO DDS INC.
Entity Type:Organization
Organization Name:KIRILL KVITKO DDS INC.
Other - Org Name:ALPHA DENATL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRILL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:KVITKO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-907-8383
Mailing Address - Street 1:14378 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-2756
Mailing Address - Country:US
Mailing Address - Phone:818-907-8383
Mailing Address - Fax:818-907-8380
Practice Address - Street 1:14378 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-2756
Practice Address - Country:US
Practice Address - Phone:818-907-8383
Practice Address - Fax:818-907-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45382261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental