Provider Demographics
NPI:1831217652
Name:MURDZHEVA, MARIYA G (DDS)
Entity type:Individual
Prefix:MS
First Name:MARIYA
Middle Name:G
Last Name:MURDZHEVA
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 1:3607 E BELL RD
Mailing Address - Street 2:STE 5
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2152
Mailing Address - Country:US
Mailing Address - Phone:602-296-4664
Mailing Address - Fax:602-296-4787
Practice Address - Street 1:3607 E BELL RD
Practice Address - Street 2:STE 5
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2152
Practice Address - Country:US
Practice Address - Phone:602-296-4664
Practice Address - Fax:602-296-4787
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD6029122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ857138Medicaid