Provider Demographics
NPI:1326269929
Name:SMIRNOVA, JULIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:SMIRNOVA
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 1:596 ANDERSON AVE
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010
Mailing Address - Country:US
Mailing Address - Phone:201-941-5522
Mailing Address - Fax:201-941-5822
Practice Address - Street 1:596 ANDERSON AVE
Practice Address - Street 2:SUITE 304
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010
Practice Address - Country:US
Practice Address - Phone:201-941-5522
Practice Address - Fax:201-941-5822
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI 216541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice