Provider Demographics
NPI:1952435778
Name:YAROVITSKY, IRINA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:IRINA
Middle Name:A
Last Name:YAROVITSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314B E LEGEND CT
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44143-3678
Mailing Address - Country:US
Mailing Address - Phone:440-364-3248
Mailing Address - Fax:
Practice Address - Street 1:8191 BROADVIEW RD
Practice Address - Street 2:HUDEC DENTAL
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44147-1661
Practice Address - Country:US
Practice Address - Phone:216-485-5788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300223411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice