Provider Demographics
NPI:1689729634
Name:KRIVOSHEYEVA, VALENTINA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:VALENTINA
Middle Name:
Last Name:KRIVOSHEYEVA
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 1:680 W 204TH ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-3003
Mailing Address - Country:US
Mailing Address - Phone:212-569-4652
Mailing Address - Fax:212-569-4644
Practice Address - Street 1:680 W 204TH ST APT 1C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-3003
Practice Address - Country:US
Practice Address - Phone:212-569-4652
Practice Address - Fax:212-569-4644
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0461051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice