MEDICARE: DR. IRINA A. YAROVITSKY DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30022341	OH

General Provider Information

NPI Number	:	1952435778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IRINA A. YAROVITSKY DMD

Provider Business Mailing Address
First Line	:	314B E LEGEND CT
Second Line	:
City	:	HIGHLAND HTS
State	:	OH
Zip	:	44143-3678
Country	:	US
Telephone Number	:	440-364-3248
Fax Number	:

Provider Business Practice Location Address
First Line	:	8191 BROADVIEW RD
Second Line	:	HUDEC DENTAL
City	:	CLEVELAND
State	:	OH
Zip	:	44147-1661
Country	:	US
Telephone Number	:	216-485-5788
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	04/17/2013

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