Provider Demographics
NPI:1760350953
Name:CARVONIS, KRYSTELE (DMD)
Entity type:Individual
Prefix:
First Name:KRYSTELE
Middle Name:
Last Name:CARVONIS
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 1:780 NE 69TH ST APT 2405
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33138-5754
Mailing Address - Country:US
Mailing Address - Phone:786-338-8972
Mailing Address - Fax:
Practice Address - Street 1:780 NE 69TH ST APT 2405
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33138-5754
Practice Address - Country:US
Practice Address - Phone:786-338-8972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20620122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty