Provider Demographics
NPI:1336487305
Name:SOLDATENKO, DENIS (RVT)
Entity Type:Individual
Prefix:
First Name:DENIS
Middle Name:
Last Name:SOLDATENKO
Suffix:
Gender:M
Credentials:RVT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 WESTWOOD BLVD
Mailing Address - Street 2:207
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-4670
Mailing Address - Country:US
Mailing Address - Phone:310-401-1398
Mailing Address - Fax:
Practice Address - Street 1:1902 WESTWOOD BLVD
Practice Address - Street 2:207
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-4670
Practice Address - Country:US
Practice Address - Phone:310-401-1398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-24
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDARDMS # 1049972471V0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471V0105XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistVascular Sonography