Provider Demographics
NPI:1841347531
Name:SPUNDE, IVLETA (DDS)
Entity type:Individual
Prefix:DR
First Name:IVLETA
Middle Name:
Last Name:SPUNDE
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 1:1900 WEBSTER ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94612-2946
Mailing Address - Country:US
Mailing Address - Phone:510-682-0296
Mailing Address - Fax:510-834-4323
Practice Address - Street 1:1900 WEBSTER ST
Practice Address - Street 2:SUITE A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-2946
Practice Address - Country:US
Practice Address - Phone:510-682-0296
Practice Address - Fax:510-834-4323
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice