Provider Demographics
NPI:1376701268
Name:MIHAYCHUK, NINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NINA
Middle Name:
Last Name:MIHAYCHUK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:NINA
Other - Middle Name:BOYKO
Other - Last Name:MIHAYCHUK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:15429 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-3869
Mailing Address - Country:US
Mailing Address - Phone:301-879-2127
Mailing Address - Fax:
Practice Address - Street 1:13975 CONNECTICUT AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2921
Practice Address - Country:US
Practice Address - Phone:301-598-3951
Practice Address - Fax:301-603-0861
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD107491223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics