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General NPI Number Information
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NPI Number | 1215437645
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Entity Type | Individual
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Provider Name | BRIANNA ESTELLE DAVYDOV DDS
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Gender | Female
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 08/08/2024
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Provider Practice Location Address
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Address Line | 219 54TH ST
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City | BROOKLYN
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State | NY
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Zip | 11220-2610
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Country | US
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Telephone | 347-377-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 1362 27TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-1509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 060989
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License Number State | NY
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