Healthcare Provider Details

I. General information

NPI: 1083548366
Provider Name (Legal Business Name): CARLOS SANTOS ZIVEC RDH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 1537 CARLOS ZIVEC
DILLINGHAM AK
99576-1537
US

IV. Provider business mailing address

PO BOX 1537
DILLINGHAM AK
99576-1537
US

V. Phone/Fax

Practice location:
  • Phone: 907-842-5201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2133
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: