Provider Demographics
NPI:1558982934
Name:ZAVLANOV, ALAINA DANIELLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALAINA
Middle Name:DANIELLE
Last Name:ZAVLANOV
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ALAINA
Other - Middle Name:DANIELLE
Other - Last Name:EDELMUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9001 63RD AVE
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2837
Mailing Address - Country:US
Mailing Address - Phone:773-656-6749
Mailing Address - Fax:
Practice Address - Street 1:5645 MAIN ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5045
Practice Address - Country:US
Practice Address - Phone:718-670-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-27
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062064122300000X, 1223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program