Provider Demographics
NPI:1497439939
Name:HREBESHCHENKO, KHRYSTYNA (DMD)
Entity Type:Individual
Prefix:
First Name:KHRYSTYNA
Middle Name:
Last Name:HREBESHCHENKO
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 1:2829 GEORGETOWN DR APT F
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5062
Mailing Address - Country:US
Mailing Address - Phone:848-459-7895
Mailing Address - Fax:
Practice Address - Street 1:2801 JOHN HAWKINS PKWY STE 175T
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-4021
Practice Address - Country:US
Practice Address - Phone:205-988-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD.007184-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice