Provider Demographics
NPI:1578081865
Name:TSVETKOV, ALEXANDRA GRIFFITH (RDH)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:GRIFFITH
Last Name:TSVETKOV
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:L
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDH
Mailing Address - Street 1:12565 FOREST CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8211
Mailing Address - Country:US
Mailing Address - Phone:720-413-8443
Mailing Address - Fax:
Practice Address - Street 1:17002 E MAINSTREET STE H
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4961
Practice Address - Country:US
Practice Address - Phone:720-842-1900
Practice Address - Fax:303-534-5290
Is Sole Proprietor?:No
Enumeration Date:2017-09-06
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002023851124Q00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist