Provider Demographics
NPI:1437230968
Name:DR V CONSTANTINESCU CO
Entity Type:Organization
Organization Name:DR V CONSTANTINESCU CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CONSTANTINESCU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-251-3672
Mailing Address - Street 1:13506 LORAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111
Mailing Address - Country:US
Mailing Address - Phone:216-251-3672
Mailing Address - Fax:216-251-3618
Practice Address - Street 1:13506 LORAIN AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111
Practice Address - Country:US
Practice Address - Phone:216-251-3672
Practice Address - Fax:216-251-3618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30017128122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0496726Medicaid
OH0496726Medicaid