Provider Demographics
NPI:1659933208
Name:CRISTINA MARKIEWICZ, D.D.S. INC.
Entity Type:Organization
Organization Name:CRISTINA MARKIEWICZ, D.D.S. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-312-0658
Mailing Address - Street 1:400 S REINO RD STE 100
Mailing Address - Street 2:
Mailing Address - City:NEWBURY PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91320-4285
Mailing Address - Country:US
Mailing Address - Phone:805-498-0400
Mailing Address - Fax:
Practice Address - Street 1:400 S REINO RD STE 100
Practice Address - Street 2:
Practice Address - City:NEWBURY PARK
Practice Address - State:CA
Practice Address - Zip Code:91320-4285
Practice Address - Country:US
Practice Address - Phone:498-040-0805
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental