Provider Demographics
NPI:1912562554
Name:YONAIEV, ZIVA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ZIVA
Middle Name:
Last Name:YONAIEV
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 1:6550 WETHEROLE ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4767
Mailing Address - Country:US
Mailing Address - Phone:347-256-8737
Mailing Address - Fax:
Practice Address - Street 1:425 MADISON AVE RM 500
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1170
Practice Address - Country:US
Practice Address - Phone:212-758-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
NY061492-011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program