Provider Demographics
NPI:1851102693
Name:KLAVY USHEVA DMD
Entity type:Organization
Organization Name:KLAVY USHEVA DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KLAVDIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:USHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:832-798-8298
Mailing Address - Street 1:2615 WILLOW PARK LN
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3985
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:413 E PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5149
Practice Address - Country:US
Practice Address - Phone:281-482-7252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty