Provider Demographics
NPI:1104424670
Name:KVITKINA, OLGA (DDS)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:KVITKINA
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 1:10004 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6103
Mailing Address - Country:US
Mailing Address - Phone:918-505-9237
Mailing Address - Fax:
Practice Address - Street 1:3600 QUEBEC ST FL 2
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80207-1609
Practice Address - Country:US
Practice Address - Phone:303-355-1818
Practice Address - Fax:303-835-3224
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.00204985122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice