Provider Demographics
NPI:1700274651
Name:MARKOVA-MITEV, IVETA (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:IVETA
Middle Name:
Last Name:MARKOVA-MITEV
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W TENNYSON RD
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-5236
Mailing Address - Country:US
Mailing Address - Phone:510-782-4470
Mailing Address - Fax:
Practice Address - Street 1:680 W TENNYSON RD
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-5236
Practice Address - Country:US
Practice Address - Phone:510-782-4470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA642861223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry