Provider Demographics
NPI:1720431349
Name:IEVA DABEKA DDS
Entity Type:Organization
Organization Name:IEVA DABEKA DDS
Other - Org Name:EVA FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IEVA
Authorized Official - Middle Name:
Authorized Official - Last Name:DABEKA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-890-3408
Mailing Address - Street 1:11817 98TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-4214
Mailing Address - Country:US
Mailing Address - Phone:425-284-4455
Mailing Address - Fax:425-284-4451
Practice Address - Street 1:11817 98TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-4214
Practice Address - Country:US
Practice Address - Phone:425-284-4455
Practice Address - Fax:425-284-4451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty