Provider Demographics
NPI:1457427486
Name:EWELINA M KALINOWSKA SZYSZKA DDS PA
Entity Type:Organization
Organization Name:EWELINA M KALINOWSKA SZYSZKA DDS PA
Other - Org Name:DENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EWELINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:KALINOWSKA SZYSZKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PA
Authorized Official - Phone:727-443-7353
Mailing Address - Street 1:1237 S MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756
Mailing Address - Country:US
Mailing Address - Phone:727-443-7353
Mailing Address - Fax:727-443-2144
Practice Address - Street 1:1237 S MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756
Practice Address - Country:US
Practice Address - Phone:727-443-7353
Practice Address - Fax:727-443-2144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16370122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1634305OtherUNITED CONCORDIA
85642OtherBCBS