Provider Demographics
NPI:1326545278
Name:DANCHENKO, KATERINA (DMD)
Entity Type:Individual
Prefix:
First Name:KATERINA
Middle Name:
Last Name:DANCHENKO
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 1:17 S WARREN ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-4506
Mailing Address - Country:US
Mailing Address - Phone:973-328-9100
Mailing Address - Fax:
Practice Address - Street 1:17 S WARREN ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-4506
Practice Address - Country:US
Practice Address - Phone:973-328-9100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-08
Last Update Date:2020-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI027159001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice