Provider Demographics
NPI:1699367912
Name:ZIVKOVIC DENTISTRY PC
Entity Type:Organization
Organization Name:ZIVKOVIC DENTISTRY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOVANKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIVKOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-701-1225
Mailing Address - Street 1:3046 35TH ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4702
Mailing Address - Country:US
Mailing Address - Phone:718-701-1225
Mailing Address - Fax:
Practice Address - Street 1:3046 35TH ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-4702
Practice Address - Country:US
Practice Address - Phone:718-701-1225
Practice Address - Fax:718-701-1265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty