Healthcare Provider Details

I. General information

NPI: 1164123204
Provider Name (Legal Business Name): EFTIXIA RIZOV DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13440 SPRINGFIELD BLVD
SPRINGFIELD GARDENS NY
11413-1403
US

IV. Provider business mailing address

23 FLINTWOOD CT.
TORONTO ONTARIO
M2J 3P1
CA

V. Phone/Fax

Practice location:
  • Phone: 929-242-2224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number06485701
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: