Provider Demographics
NPI:1073881306
Name:TALALENKO, SVETLANA (DMD)
Entity Type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:TALALENKO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2515 NORTHBROOKE PLAZA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8088
Mailing Address - Country:US
Mailing Address - Phone:239-593-6488
Mailing Address - Fax:239-593-0549
Practice Address - Street 1:2515 NORTHBROOKE PLAZA DR STE 100
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8088
Practice Address - Country:US
Practice Address - Phone:239-593-6488
Practice Address - Fax:239-593-0549
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist