Provider Demographics
NPI:1649609496
Name:BADINEVA, FAINA M (DDS)
Entity type:Individual
Prefix:DR
First Name:FAINA
Middle Name:M
Last Name:BADINEVA
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 1:1518 WALNUT ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3403
Mailing Address - Country:US
Mailing Address - Phone:215-772-0707
Mailing Address - Fax:215-772-0271
Practice Address - Street 1:1518 WALNUT ST STE 400
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3403
Practice Address - Country:US
Practice Address - Phone:215-772-0707
Practice Address - Fax:215-772-0271
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031415L122300000X
NY049062122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist