Provider Demographics
NPI:1336525344
Name:AVIV, NAAMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NAAMA
Middle Name:
Last Name:AVIV
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 1:20 FALLING WATER RD
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NC
Mailing Address - Zip Code:28390-7005
Mailing Address - Country:US
Mailing Address - Phone:516-724-7234
Mailing Address - Fax:
Practice Address - Street 1:3020 N MAIN ST STE 270
Practice Address - Street 2:
Practice Address - City:HOPE MILLS
Practice Address - State:NC
Practice Address - Zip Code:28348-1788
Practice Address - Country:US
Practice Address - Phone:910-716-0102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-03
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN24698122300000X
MI29010216681223G0001X
NC11694122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice