Provider Demographics
NPI:1093332272
Name:KINAL, LIUDMYLA
Entity Type:Individual
Prefix:
First Name:LIUDMYLA
Middle Name:
Last Name:KINAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1092 MADISON AVENUE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5256 S. MISSION RD
Practice Address - Street 2:ST. 703-LK
Practice Address - City:BONSALL
Practice Address - State:CA
Practice Address - Zip Code:92003
Practice Address - Country:US
Practice Address - Phone:760-536-3094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-03
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1067521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice