Provider Demographics
NPI:1386088516
Name:IANAKIEVA, DESSISLAVA KIRILOVA (M D)
Entity type:Individual
Prefix:
First Name:DESSISLAVA
Middle Name:KIRILOVA
Last Name:IANAKIEVA
Suffix:
Gender:F
Credentials:M D
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Other - Credentials:
Mailing Address - Street 1:PO BOX 26666
Mailing Address - Street 2:PHS PROVIDER ENROLLMENT
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6666
Mailing Address - Country:US
Mailing Address - Phone:505-923-6770
Mailing Address - Fax:505-923-5354
Practice Address - Street 1:8300 CONSTITUTION AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7613
Practice Address - Country:US
Practice Address - Phone:505-291-2700
Practice Address - Fax:505-291-2989
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2022-07-21
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Provider Licenses
StateLicense IDTaxonomies
NMMD2017-0624207Q00000X, 207QS1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine